Incidence Of Adverse Reactions Research Articles

The efficacy and safety of modified ultraearly oral hydration for alleviating thirst in patients after thoracoscopic surgery: a prospective randomized controlled trial

ObjectivePostoperative fasting following thoracoscopic surgery can cause intense thirst and oral discomfort. However, there is currently no research on ultraearly oral hydration (UEOH) in middle-aged or elderly patients after thoracoscopic surgery. The aim of this study was to investigate the effectiveness and safety of UEOH for improving oral discomfort after thoracoscopic surgery.MethodsThis single-center prospective double-blind randomized controlled trial was conducted from April 2022 to November 2023. A total of 64 middle-aged and elderly patients who underwent the first thoracoscopic surgery on the day were enrolled at our institution. Postoperatively, in the Postanesthesia Care Unit (PACU), patients were randomly assigned at a 1:1 ratio to either the UEOH group or the standard care (SC) group. The primary outcome was the patient’s thirst score at 6 h after surgery. Secondary outcomes included the incidence of postoperative oral discomfort; pain scores; the occurrence of adverse reactions such as nausea, vomiting, regurgitation and aspiration; anxiety scores on the first postoperative day; the time to first flatus; and recovery satisfaction scores.ResultsThe demographic and surgical characteristics were similar between the two groups. Patients in the UEOH group had lower thirst scores 6 h after surgery than did those in the SC group(16.1 ± 6.70 vs. 78.4 ± 8.42, P < 0.01). The incidence of postoperative oral discomfort (P < 0.01), anxiety scores on the first postoperative day (P<0.05), and time to first flatus (P<0.05) were better in the UEOH group. Additionally, the incidences of adverse reactions, such as postoperative nausea, vomiting, regurgitation and aspiration, were similar between the two groups (P>0.05).ConclusionFor middle-aged and elderly patients undergoing thoracoscopic surgery, the use of a modified UEOH protocol postoperatively can improve thirst and promote gastrointestinal recovery without increasing complications.Trial registrationThis single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 07/12/2023 with the registration number ChiCTR2300078425.

Clinical efficacy of montelukast sodium combination therapy for cough variant asthma in children: A meta-analysis.

This meta-analysis aims to assess the clinical effectiveness of combination therapy with montelukast sodium for the treatment of cough variant asthma (CVA) in children, intending to provide clinical evidence and data to guide the selection of clinical therapy. A literature review was conducted using numerous databases, including China National Knowledge Infrastructure (CNKI), Wanfang database, Embase, PubMed, and Web of Science, from inception to December 2023. Trials meeting the criteria for the combined treatment of montelukast sodium for CVA in children were included. Stata 16.0 software was utilized for meta-analysis. The combined treatment group received montelukast sodium in addition to the control group, while the control group received budesonide, fluticasone propionate, salmeterol-fluticasone, or ketotifen alone. This investigation included 18 papers. All subjects were from the Chinese population. Compared to the control group, the combined treatment group demonstrated a higher effective rate (relative ratio [RR] = 1.23, 95% confidence interval [CI]: 1.18-1.29, p < .001), but no difference in the incidence of adverse reactions (RR = 0.65, 95%CI: 0.42-1.02, p = .060) after treatment. Moreover, the peak expiratory flow (PEF) (SMD = 1.69, 95%CI: 1.09-2.30, p < .001), forced vital capacity (FVC) (SMD = 1.67, 95%CI: 0.94-2.39, p < .001), forced expiratory volume in 1 s (FEV1) (SMD = 1.74, 95%CI: 1.09-2.40, p < .001), and FEV1/FVC (SMD = 1.84, 95%CI: 0.41-3.28, p = .012) were significantly higher in the combined treatment group than in the control group after treatment. Compared with the control group, the levels of tumor necrosis factor-α (SMD = -2.38, 95%CI: -3.22to -1.55, p < .001), IL-4 (SMD = -2.65, 95%CI: -3.26 to-2.04, p < .001), and IgE (SMD = -2.98, 95%CI: -3.24 to -2.72, p < .001) were significantly lower in the combined treatment group after treatment. The combined use of montelukast sodium in the treatment of pediatric CVA in China is associated with a significant clinical effect, making it a reasonable therapeutic approach.

Application Evaluation of Esmolol Hydrochloride-Assisted Interventional Therapy on New-Onset Atrial Fibrillation in Patients with Severe Sepsis: A Retrospective Study

Objective: This study aims to explore the application effect of adjuvant therapy with esmolol hydrochloride on new-onset atrial fibrillation (NOAF) in patients with severe sepsis. Methods: Retrospective analysis was conducted on 170 patients with NOAF and severe sepsis admitted to our hospital from January 2022 to January 2023. After excluding eight patients who did not meet the inclusion criteria, the remaining 162 patients were included in the study. Based on different treatment methods, the patients were divided into the control group (n = 83, routine treatment) and the observation group (n = 79, esmolol hydrochloride in combination with routine treatment). The cardiac function indexes such as left atrial diameter, left ventricular end-diastolic dimension, left ventricular end-systolic dimension and left ventricular ejection fraction; left atrial wall tension-related indexes, including atrial natriuretic peptide, B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide; inflammatory factors, including a C-reactive protein, high-sensitivity C-reactive protein, interleukin-6 and procalcitonin and the incidence of adverse reactions were compared between the two groups. Statistical methods were used to process and compare the above-mentioned data and index results. Results: No significant difference was observed in cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors in both groups before treatment (p &gt; 0.05). After treatment, the observation group had lower cardiac function indexes, left atrial wall tension-related indexes and inflammatory factors than the control group (p &lt; 0.05), and the incidence of adverse reactions in the two groups was similar (p &lt; 0.05). Conclusion: The adjuvant therapy with esmolol hydrochloride has a certain clinical effect on patients with severe sepsis and NOAF, which improves the cardiac function of such patients and reduces their inflammation levels up to a point, showing a clinical application value.

Biomimetic nanoparticles for effective Celastrol delivery to targeted treatment of rheumatoid arthritis through the ROS-NF-κB inflammasome axis

Previous study has indicated that Celastrol (Cel) has various physiological and pharmacological effects, including antibacterial, antioxidant, pro-apoptotic, anticancer and anti-rheumatoid arthritis (RA) effects. However, low water solubility, low oral bioavailability, narrow treatment window, and high incidence of systemic adverse reactions still limit the further clinical application of Cel. Here, aiming at effectively overcome those shortcomings of Cel to boost its beneficial effects for treating RA, we developed the leukosome (LEUKO) coated biomimetic nanoparticles (NPs) for the targeted delivery of Cel to arthritis injury area in RA. LEUKO were synthesized using membrane proteins purified from activated J774 macrophage. LEUKO and Cel-loaded LEUKO (Cel@LEUKO) were characterized using dynamic light scattering and transmission electron microscopy. Our results demonstrated that Cel@LEUKO can inhibit the inflammatory response of lipopolysaccharide (LPS) induced mouse monocyte macrophage leukemia cells (RAW264.7 cells) and human rheumatoid arthritis synovial fibroblasts (MH7A) cells through the inhibition of reactive oxygen species (ROS)-NF-κB pathway. In addition, research has shown that LEUKO effectively targets and transports Cel to the inflammatory site of RA, increased drug concentration in affected areas, reduced systemic toxicity of Cel, and reduced clinical symptoms, inflammatory infiltration, bone erosion, and serum inflammatory factors in collagen-induced arthritis (CIA) rats.

Comparison of the efficacy and safety of sodium valproate versus levetiracetam in the treatment of severe traumatic brain injury

Objective To observe the efficacy and safety of sodium valproate (VPA) compared to levetiracetam (LEV) in the treatment of severe traumatic brain injury (sTBI). Methods In this blind, prospective study, eighty-four sTBI patients who had craniotomy from August 2021 to August 2023 were randomly split into two groups through random number table method: LEV and VPA, each with 42 patients. Both received comprehensive treatment post-craniotomy. LEV group: LEV injection on surgery day, transitioning to LEV tablets from day two. VPA group: VPA injection on surgery day, switching to VPA extended-release tablets from day two. The study compared hospital stay, neurological function, clinical outcomes, seizures, and drug reactions between groups. Results The length of hospital stay showed no significant difference between the LEV and VPA groups. Both groups demonstrated improved neurological function post-treatment (NIHSS and BI scores), with no significant between-group differences. Clinical outcomes at 3 months post-treatment were similar in both groups. Seizure occurrence within 3 months after treatment showed no significant difference between the LEV (19.05%) and VPA (23.81%) groups. However, the VPA group experienced a significantly higher rate of drug-related adverse reactions (40.48%) compared to the LEV group (21.43%). Conclusion Both VPA and LEV are effective in treating sTBI, showing no significant difference in improving neurological function, daily life abilities, treatment outcomes, and seizure occurrence. However, VPA treatment exhibited a significantly higher incidence of drug-related adverse reactions compared to LEV, indicating that LEV might be a safer option for sTBI treatment.

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke.

Ischemic stroke (IS) is a widely recognized disease characterized by high prevalence, mortality, morbidity, disability, and recurrence rates. It ranks prominently in terms of mortality, constituting 60%-80% of stroke cases. To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS. This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021. The participants were divided into two groups, namely the control group (n = 80) receiving routine care and the research group (n = 92) receiving comprehensive care. Various assessment scales, including the standard swallowing function assessment scale (SSA), National Institutes of Health Stroke scale (NIHSS), European stroke scale (ESS), self-rating anxiety scale (SAS), self-rating depression scale (SDS), Barthel index (BI), and the motor function assessment scale (MAS), were employed to evaluate the improvement in swallowing function, neurological deficits, clinical outcomes, anxiety, depression, daily living activities, and motor function before and after care. Furthermore, the study compared the occurrence of adverse reactions during the nursing period, life quality before and after the intervention, rehabilitation compliance, and nursing satisfaction between the two groups. After the nursing intervention, the research group exhibited significantly improved SSA and NIHSS scores compared to the control group (P < 0.05). Moreover, both groups demonstrated significant reductions in SAS and SDS scores (P < 0.05), with the research group showing more obvious advantages (P < 0.05). Compared to the control group, the research group displayed significantly better ESS, BI, and MAS scores (P < 0.05), coupled with a lower incidence of adverse reactions (P < 0.05). Additionally, the research group demonstrated markedly higher levels of life quality, rehabilitation compliance, and nursing satisfaction compared to the control group (P < 0.05). Comprehensive nursing effectively improved swallowing function, quality of life, and patient satisfaction, highlighting its clinical significance.

Comparison of the bispectral indices of patients receiving remimazolam and propofol for general anesthesia: a randomized crossover trial

BackgroundRemimazolam is a safe and effective new benzodiazepine sedative that has unique advantages in anesthesia induction and maintenance. The differences in the electroencephalogram bispectral index (BIS) during general anesthesia between propofol and remimazolam deserve further exploration. MethodsSingle-center randomized crossover study. Patients who required multiple hysteroscopic surgery were randomly assigned to use remimazolam (0.27 mg/kg for induction and 1 mg/kg/h for maintenance) first and then propofol (2.0 mg/kg for induction and 6 mg/kg/h for maintenance) during hysteroscopic surgery again 3 months later, or in the opposite order. Both drugs were used at the latest ED95 for unconsciousness. The BIS values (primary endpoint), intraoperative conditions, and incidence of adverse reactions (secondary endpoints) were compared at each time point. BIS values were analyzed with a mixed model of repeated measurements (MMRM). ResultsSeventeen patients completed the study. The lowest BIS value in the remimazolam regimen was significantly higher than that in the propofol regimen (p = 0.001). The MMRM analysis of the BIS values revealed significant differences between the regimens at each time point (p < 0.001). The intraoperative diastolic blood pressure and heart rate changes were smaller, the recovery was faster, and there were fewer adverse reactions and less injection pain, but a greater incidence of intraoperative body movement and hiccups, in the remimazolam regimen. ConclusionThe trial indicated that remimazolam maintained a higher BIS level than propofol. The correlation between the BIS and the depth of anesthesia induced by remimazolam needs to be further studied. Trial registrationThis trial is registered at ClinicalTrials.gov: ChiCTR2200064551

Effect of furosemide combined with continuous renal replacement therapy on cardiorenal function and inflammatory response in patients with chronic renal and heart failure after hemodialysis

Purpose: To determine the effect of furosemide combined with continuous renal replacement therapy (CRRT) on cardiorenal function and inflammatory response in patients with chronic renal failure (CRF) and heart failure after hemodialysis. &#x0D; Methods: 130 patients with both CRF and heart failure, who underwent hemodialysis at the Second Hospital Affiliated to Hainan Medical College, China, from October 2020 to October 2022 were recruited as study subjects. They were randomly divided into two groups, with control group administered the Continuous Renal Replacement Therapy (CRRT) while study group received furosemide in addition. The study assessed the clinical outcomes, cardiorenal function and inflammatory factors before and after treatment. Additionally, adverse reactions during treatment were documented for both groups. &#x0D; Results: Study group exhibited a significantly higher (p &lt; 0.001) total response rate compared to control group. Post-treatment, both groups displayed significant increases (p &lt; 0.05) in left ventricular ejection fraction, cardiac output and stroke volume, with study group showing significantly superior results (p &lt; 0.05). Furthermore, post-treatment, both groups experienced significant reductions (p &lt; 0.05) in serum creatinine, blood urea nitrogen, and 24-hour urinary protein levels, with study group displaying significantly lower levels (p &lt; 0.05). Additionally, the interleukin-6, interleukin-1β and tumor necrosis factor-α levels decreased significantly in both groups post-treatment, with study group exhibiting significantly lower levels (p &lt; 0.05). There was no significant difference in adverse reaction incidence between the two groups. &#x0D; Conclusion: Furosemide combined with CRRT significantly improves cardiorenal function and reduces inflammatory response in patients with CRF and heart failure after hemodialysis. Future research could optimize dosage and administration protocols, explore long-term effects and assess applicability in diverse patient populations.

Efficacy of sodium creatine phosphate in pediatric viral myocarditis and cellular immune functions

Purpose: To investigate the effectiveness of sodium creatine phosphate (SCP) in pediatric viral myocarditis, and cellular immune functions. &#x0D; Methods: Clinical data of 83 children with viral myocarditis admitted to Dezhou Traditional Chinese Medicine Hospital, China between May 2019 and June 2021 were collected and randomly assigned to control (n = 41) and study groups (n = 42). Control group (CNG) received conventional treatment for 14 days, including intravenous drip of sodium fructose diphosphate, vitamin C, and ribavirin, with the addition of prednisone if necessary. Study group (SG) received SCP in addition to conventional treatment for 14 days. Clinical efficacy, cardiac function, inflammatory and immune markers, myocardial injury, and adverse effects at the end of treatment were determined. &#x0D; Results: Results indicated a significantly higher total effective rate in study group (95.24 %) compared to control group (78.05 %) (p &lt; 0.05). Study group demonstrated significantly lower heart rates and improved cardiac output, stroke volume, and left ventricular ejection fraction after 14 days of treatment compared to control group (p &lt; 0.05). Furthermore, study group exhibited significant reduction in levels of inflammatory markers (p &lt; 0.05), enhanced cellular immune markers (p &lt; 0.05), and reduced myocardial injury and remodeling markers (p &lt; 0.05). Both groups showed similar incidence of adverse reactions. &#x0D; Conclusion: Sodium creatine phosphate (SCP) is effective in treating pediatric viral myocarditis, enhances cardiac function, restores cellular immune function, reduces inflammation, and minimizes myocardial damage and remodeling. There will be need to evaluate the long-term efficacy and prognosis of SCP in treating pediatric viral myocarditis in the future.

Chemo-immunotherapy with dinutuximab beta in patients with relapsed/progressive high-risk neuroblastoma: does chemotherapy backbone matter?

BackgroundAddition of anti-GD2 antibodies to temozolomide-based chemotherapy has demonstrated increased antitumor activity and progression-free survival in patients with relapsed/progressive high-risk neuroblastoma. However, chemo-immunotherapy is not yet approved for this indication. This study presents the chemo-immunotherapy experience in patients with relapsed/progressive high-risk neuroblastoma treated within the off-label use program of the Neuroblastoma Committee of the French Society of Pediatric Oncology (SFCE). MethodsDinutuximab beta (dB) was administered alongside temozolomide-topotecan (TOTEM) or temozolomide-irinotecan (TEMIRI) at first disease relapse/progression or topotecan-cyclophosphamide (TopoCyclo) at further relapse/progression. Real-world data on demographics, treatment, antitumor activity and safety was collected from all patients after inclusion in SACHA-France (NCT04477681), a prospective national registry, which documents safety and efficacy data on innovative anticancer therapies prescribed to patients ≤ 25 years old as compassionate or off-label use. ResultsBetween February 2021 and July 2023, 39 patients with confirmed relapsed/progressive high-risk neuroblastoma (median age 6 years, range 1–24) were treated with dB+TopoCyclo (n = 24) or dB+TOTEM/TEMIRI (n = 15) across 17 centers. In total, 163 chemo-immunotherapy cycles were administered, main toxicities were mild or moderate, with higher incidence of hematological adverse drug reactions with dB+TopoCyclo than dB+TOTEM/TEMIRI. Objective response rate was 42% for dB+TopoCyclo (CI95% 22–63%) and 40% for dB+TOTEM/TEMIRI (CI95% 16–68%). ConclusionSimilar objective response rates for dB+TopoCyclo and dB+TOTEM/TEMIRI in patients with relapsed/progressive high-risk neuroblastoma emphasize the importance of chemo-immunotherapy, irrespective of the chemotherapy backbone.

Safety of non-ionic contrast media in CT examinations for out-patients: retrospective multicenter analysis of 473,482 patients.

This study aimed to explore the incidence of and potential risk factors for adverse drug reactions (ADRs) after non-ionic iodinated contrast media (NICM) administration for CT exams in out-patient settings in China. A total of 473,482 out-patients who underwent intravenous NICM between January 1st, 2017, and Dec 31st, 2021, were retrospectively enrolled from three institutions. The occurrence of ADRs and clinical information were recorded. Chi-square test, Poisson regression, and logistic regression analyses were used to evaluate potential ADR risk factors and correlation with demographics, season, and NICM type. Among the 473,482 patients (mean age 55.22 ± 14.85; 253,499 male) who received intravenous NICM, the overall ADR incidence was 0.110% (522 of 473,482), with 0.099% acute-related drug reactions (469 of 473,482) and 0.0004% serious ADRs (two of 473,482). Iopromide was associated with a higher risk of acute ADRs. Late ADRs were more frequently observed with iodixanol 320. Multi-level logistic regression of patients with acute ADRs and a control group (matched 1:1 for age, gender, NICM, prescriber department, and institution) showed that summer (adjusted OR = 1.579; p = 0.035) and autumn (adjusted OR = 1.925; p < 0.001) were risk factors of acute ADRs. However, underlying disease and scanned body area were not related to a higher ADR incidence. The use of NICM for out-patients is in general safe with a low ADR incidence. The type of contrast medium (iopromide) and the seasons (summer and autumn) were associated with a higher risk of acute ADRs. Late ADRs were more often observed with iodixanol. In comparison to in-patients, out-patients may be exposed to higher risk due to a lack of extensive risk screening, less nursing care, and higher throughput pressure. Safety data about NICM from a large population may complement guidelines and avoid ambiguity. • The incidence and risk factors for adverse events after using non-ionic iodinated contrast media are complex in out-patients. • Non-ionic iodinated contrast media are safe for out-patients and the overall incidence of adverse drug reactions was 0.110%. • There is a higher risk of acute adverse drug reactions in summer and autumn.

Effects of ultrasound-guided lumbar plexus and sacral plexus block combined with general anesthesia on the anesthetic efficacy and surgical outcomes in elderly patients undergoing intertrochanteric fracture surgery: a randomized controlled trial

BackgroundSurgery for intertrochanteric fractures in elderly patients is challenging due to the risk of severe pain and significant stress responses. We investigated the effects of a combined approach of ultrasound-guided lumbar plexus and sacral plexus block with general anesthesia on anesthetic efficacy and surgical outcomes in these patients.MethodsA randomized controlled trial was conducted involving 150 elderly patients, divided into two groups: the combined anesthesia group (receiving ultrasound-guided lumbar plexus and sacral plexus block along with general anesthesia) and the general anesthesia alone group. Outcome measures included hemodynamic parameters, postoperative pain levels (VAS scores), postoperative recovery times, and incidence of adverse reactions.ResultsIn the combined anesthesia group, the patients had more stable intraoperative hemodynamics, lower postoperative VAS scores at 1, 3, and 6 h, and faster recovery times (eye-opening upon command and return of respiratory function) compared to the general anesthesia group. Furthermore, the incidence of adverse reactions was significantly lower in the combined anesthesia group.ConclusionsUltrasound-guided lumbar plexus and sacral plexus block combined with general anesthesia enhanced the anesthetic efficacy and improved surgical outcomes in elderly patients undergoing intertrochanteric fracture surgery.

Dienogest in conjunction with GnRH-a for postoperative management of endometriosis.

Objective: The aim of this study is to assess the postoperative efficacy of the combined administration of dienogest (DNG) and gonadotropin-releasing hormone agonists (GnRH-a) in patients diagnosed with endometriosis (EMS), while acknowledging the extensive use of DNG in the extended therapeutic management of EMS. Methods: In this retrospective study, a cohort of 154 patients who underwent conservative surgical intervention for EMS were scrutinized. The cohort was stratified into two distinct groups based on their prescribed pharmacological regimens. Group A, 70 patients received postoperative oral administration of DNG at a dosage of 2mg/day, whereas Group B, 84 patients underwent treatment involving 3 to 4 injections of GnRH-a post-surgery, followed by DNG therapy. Parameters assessed included pelvic pain visual analog scale (VAS) scores, quality of life metrics (EHP-5), and the incidence of adverse reactions within both groups. Results: Both groups exhibited sustained low VAS scores following the prescribed treatments. The predominant occurrence of adverse bleeding patterns manifested predominantly within the initial 6months of the treatment. Notably, Group B demonstrated a significantly diminished of experiencing frequent and irregular bleeding in comparison to the DNG group (20.0% vs. 8.3%, 12.9% vs. 3.6%, p < 0.05). The administration of GnRH-a did not exacerbate the impact on bone health. Subsequent to health promotion interventions, the incidence of weight gain in both groups declined to 7.1% during the 6-month follow-up (p < 0.05). Group B exhibited a 100% satisfaction rate with the treatment, concomitant with a noteworthy reduction in EHP-5 scores (p < 0.05). Patients with deep infiltrating endometriosis (DIE) nodules displayed marginally higher postoperative VAS scores than their non-DIE counterparts (0.89 ± 0.96 vs. 0.49 ± 0.78). However, with sustained medication use, pain scores within the DIE group exhibited a continual decrease, maintaining a low level of 0.29 ± 0.67 at 12months and beyond. Conclusion: The short-term adjunctive use of GnRH-a prior to DNG treatment postoperatively in patients with EMS proves efficacious in mitigating early adverse bleeding, enhancing patient adherence, and improving overall quality of life. Notably, this therapeutic approach demonstrates favorable safety profiles and is equally effective in patients with DIE.

Advantages of Edaravone Dextrosanol in Elderly Patients with Acute Cerebral Infarction versus Edaravone: A preliminary study

Objective To analyze and compare the application advantages of Edaravone and Edaravone Dextrosanol in elderly patients with acute cerebral infarction (ACI). Methods A retrospective analysis of clinical data from 113 elderly AIS patients admitted to our hospital between January 2022 and January 2023 was conducted. Based on the treatment interventions received, patients were divided into a control group (n = 56) and an observation group (n = 57). The control group received Edaravone in addition to routine treatment, while the observation group received Edaravone Dextrosanol in addition to routine treatment. compared clinical outcomes, motor and neurological function, self-care ability, neural damage indicators, inflammatory markers, and adverse reactions between the two groups. Results ① Total effective rate in the observation group (91.23%) was significantly higher than that in the control group (75.00%) (P < 0.05). ② After treatment, higher FMA and Barthel scores, lower NDS score in observation group vs control group (P < 0.05). ③ After treatment, lower NSE and MMP-9 levels in observation group vs control group (P < 0.05). ④ After treatment, lower IL-1β, IL-6, and hs-CRP levels in observation group vs control group (P < 0.05). ⑤ No significant difference in adverse reaction incidence between groups (P > 0.05). Conclusion Edaravone Dextrosanol proves effective in treating elderly AIS patients. Compared to Edaravone, it boosts effectiveness, neurological recovery, motor & self-care abilities, and reduces neural damage & inflammation markers. Its safety profile is comparable to Edaravone, without significantly increasing adverse reactions. These findings suggest that Edaravone Dextrosanol is worthy of clinical promotion.

Incidence, characteristics, and risk factors of drug-associated muscle adverse reaction: a retrospective real-world study of inpatients.

To analyze the clinical characteristics, incidence, and distribution of drug-associated muscle adverse reactions (DAMAR) in real-world inpatients, to provide valuable references for clinical medication use. We conducted an automatic retrospective monitoring of inpatients from May 1, 2022, to April 30, 2023, to collect information on adverse drug reactions (ADR) of patients and conducted subsequent analyses. Among 102,430 hospitalizations, 1106 cases of DAMARs were identified, yielding an incidence of 1.08%, including 125 cases of rhabdomyolysis at an incidence of 0.12%. Seventy-five percent of the patients experienced muscle adverse reactions within 5 days after taking medication, with a median elevated creatine kinase (CK) value of 420.4 IU/L. Risk factors of DAMAR include age ≥ 65, male sex, obesity, hypertension, hepatic and renal insufficiency, and anemia. No significant correlation was observed between the duration of surgery and CK elevation, while the surgical procedure itself had an impact. The 114 drugs associated were predominantly nervous system drugs, anti-infectives for systemic use, and cardiovascular system drugs, with levofloxacin, pregabalin, and parecoxib being the most frequently associated drugs. Healthcare professionals should be vigilant with patients exhibiting the identified risk factors. Monitoring creatine kinase and related indices when using myotoxic drugs is crucial to preventing serious adverse reactions, ultimately preserving patients' quality of life.

Surveillance of COVID-19 vaccines: A comprehensive analysis of the first immunization drive in Ecuador

The initial phase of the COVID-19 vaccination in Ecuador occurred between April and November 2021. Initially, it focused on priority populations, including health professionals and other front-line workers. During this period, there was limited knowledge about the vaccine's adverse effects. A non-probability, observational study was conducted among university staff in Guayaquil, Ecuador, who received the AstraZeneca vaccine (n = 423) between April and November 2021. This study aimed to compare the acute adverse reactions by doses and to report the incidence of long-term adverse reactions within the AstraZeneca group. As a result, comparing acute adverse reactions between doses, the odds ratio for local pain, headache, muscle pain, fever, and chills are statistically higher after the first dose than the second dose. Survival curves indicated these symptoms appeared mainly within the first 6 h post-vaccination. This is the first pharmacovigilance study from Ecuador that analyzes survival probabilities for the AstraZeneca vaccine's adverse effects.

Comparison of intravesical chemotherapy regimens after radical nephroureterectomy for upper tract urothelial carcinoma and analysis of risk factors for postoperative recurrence.

Upper tract urothelial carcinoma (UTUC) is a relatively rare but aggressive type of urologic cancer that includes renal pelvic tumors and ureteral tumors with a poor prognosis. Full-length nephroureterectomy plus sleeve bladder resection is the standard treatment for the disease, but patients are prone to recurrence of bladder tumors after surgery. Intravesical infusion therapy is the main means to prevent the recurrence and progression of bladder cancer. Epirubicin and gemcitabine are widely used in clinical practice as first-line or salvage therapy for intravesical chemotherapy; however, the efficacy of these agents is rarely discussed. The purpose of this study was to investigate the effects of epirubicin and gemcitabine on the occurrence of bladder cancer after radical nephroureterectomy for UTUC and to analyze the risk factors affecting the recurrence of postoperative bladder cancer. A total of 215 patients with diagnosed UTUC and treated in our hospital from June 2019 to August 2021 were retrospectively selected as the research subjects, and they were divided into an observation group (120 cases) and a control group (95 cases) according to different treatment methods. The patients in the control group were treated with epirubicin, while those in the observation group received gemcitabine. All patients were followed up by telephone or outpatient examination for 12 months to record the occurrence of adverse reactions. The occurrence of bladder cancer was recorded at 3 months, 6 months, and 12 months after the surgery. According to the occurrence of bladder cancer after surgery, the patients were divided into a bladder cancer group (63 cases) and a non-bladder cancer group (152 cases). Multivariate Logistic regression analysis was used to analyze the risk factors of bladder cancer after surgery. The total incidence of adverse reactions in the control group was 49.47%, which was higher than that in the observation group with 15.00% (p<0.01). The incidence of bladder tumors in the observation group and the control group was 0.00% and 2.11% at 3 months, 5.00% and 8.42% at 6 months, 13.33% and 15.79% at 12 months, without significant difference (p>0.05). After 12 months of perfusion, the levels of acidic fibroblast growth factor (aFGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) in the two groups were significantly lower than those before perfusion (p<0.05). In the observation group, the levels of these three factors were slightly decreased compared with those in the control group, without a significant difference (p>0.05). Between the bladder cancer and non-bladder cancer groups, there were significant differences in tumor location, number of lesions, tumor stage, preoperative ureteral examination, and preoperative history of bladder cancer (p<0.05). The above indexes were all risk factors for postoperative bladder cancer (p<0.05). Epirubicin and gemcitabine reduced the occurrence of bladder cancer and effectively inhibited tumor angiogenesis after radical nephroureterectomy for UTUC. The tumor location, number of lesions, tumor stage, preoperative ureteral examination, and preoperative history of bladder cancer were risk factors for postoperative bladder cancer.

Impact of prophylactic wound closure in colorectal ESD on postoperative wound complications: A meta-analysis.

Endoscopic submucosa dissection (ESD) has been applied extensively in the treatment of large intestine tumours due to its high total excision ratio. Nevertheless, there is a high incidence of adverse reactions in colon ESD, and the efficacy of prophylactic ESD following ESD in prevention of postoperative haemorrhage is still disputed. The purpose of this meta-analysis is to evaluate the effectiveness of prophylaxis of wound closure in large intestine ESD after operation. For eligibility, we looked through three databases: PubMed, Embase and Cochrane Library. Heterogenity was measured by means of a chi-square method of Q-statistic and an I2 test. Fixed or random effects models were used for data processing. Based on the retrieval policy, we found a total of 1286 papers, and then we collected nine papers to extract the data. Regarding postoperative haemorrhage, there was a significant reduction in the risk of wound haemorrhage in the wound closure group than in the control group (OR, 0.29; 95% CI, 0.19-0.44 p < 0.0001). No statistical significance was found in the incidence of perforation in the wound closure and the control group (OR, 0.45; 95% CI, 0.19-1.03 p = 0.06). There was a significant reduction in the incidence of postoperation fever among those in the wound closure group than in the control group (OR, 0.37; 95% CI, 0.15-0.93 p = 0.04). Preventive endoscopic closure decreased the rate of ESD in colon disease, but did not significantly decrease the rate of postoperation perforation and postoperative fever. Future research will be required to clarify the risk factors and classify high-risk individuals in order to formulate a cost-effective prevention strategy.

Effect of orthodontics combined with fibre-reinforced composite resin-bonded fixed partial denture on anterior dentition defects with minimal vertical intermaxillary space.

Prosthodontics are often performed to treat patients with malocclusion and dentition defects. However, single prosthodontics cannot properly correct the disharmony of teeth, dental arch and other parts affected by malocclusion, and some patients may have difficulty in recovering the occlusal function due to poor prosthodontics. This study aims to investigate the effect of orthodontics combined with fibre-reinforced composite resin-bonded fixed partial denture (FRC-RBFPD) on anterior dentition defects with minimal vertical intermaxillary space. Sixty-two patients with anterior dentition defects with minimal vertical mandibular space admitted to our hospital between March 2021 and May 2023 were enrolled in this study. The participants were divided into the observation group (31 cases) and the control group (31 cases), according to the treatment plan. The control group was treated with traditional therapy, and the observation group was treated with orthodontic combined FRC-RBFPD therapy. Periodontal conditions (periodontal pocket depth [PD], the plaque index [PLI], the sulcus bleeding index [SBI]), levels of inflammatory factors in gingival crevicular fluid (high mobility group box 1 [HMGB1]), myeloid cell triggering receptor-1 (TREM-1), monocyte chemoattractant protein-1 (MCP-1), pain (visual analogue scale [VAS]), the clinical response rate and the incidence of adverse reactions were collected and compared. After 1, 3, 5 and 9 months following treatment, the scores of the PD, PLI, SBI, HMGB1, VAS, TREM-1 and MCP-1 in the observation group were found to be lower than those in the control group (FPD treatment= 352.532, FPLI score treatment= 112.341, FSBI score treatment= 79.479, FVAS score treatment= 96.132, FHMGB1 treatment= 52.532, FTREM-1 score treatment= 64.593, FMCP-1 score treatment= 53.582, and they were all statistically significant P< 0.05). There was a statistically significant difference in the response rate between the two groups (97.77% vs. 80.65%, χ2= 4.026, P= 0.045). No statistically significant difference was observed in the incidence of adverse reactions between the two groups (6.45% vs. 16.13%, χ2= 1.449, P= 0.229). Orthodontics combined with FRC-RBFPD shows an ideal restorative effect on patients with anterior dentition defects and minimal vertical intermaxillary space.

The Clinical Effect of External Application of Scorzonera Glabra Herpes Ointment on the Treatment of Herpes Zoster in the Ear

Objective To Exploring the effect of external application of scorzonera glabra Herpes Ointment on the treatment of Herpes zoster of the ear (HZE). Methods Select 100 HZE patients who met the inclusion criteria and were treated at the 988th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force from January 2021 to June 2023. Divide into a treatment group and a control group using a random number table method, with 50 cases in each group. The treatment group was treated with external application of crow onion herpes ointment, while the control group was treated with external application of acyclovir ointment. After 10 days of treatment, the therapeutic effect was evaluated, and the HZE comprehensive symptom and sign efficacy score and visual analogue scale (VAS) were observed and compared between the two groups on the 10th day. The time for erythema reduction, blister stop, nodulation, and detachment were observed throughout the treatment process; Compare the difference in air conduction and air bone conduction between two groups before and after treatment (1 month after treatment); Observe and compare the incidence of postherpetic neuralgia (PHN) between two groups one month after treatment. Results The difference between the two groups was statistically significant (P&lt;0.05), and the clinical effect of the treatment group was significantly better than that of the control group. Compared with the control group, the total score of HZE symptoms and signs in the treatment group was lower, and the difference was statistically significant (P&lt;0.05). The comparison of air conductance between the treatment group and the control group before and after treatment (1 month after treatment) showed that the average air conductance was (35.5 ± 4.5), (35.9 ± 4.7), (15.6 ± 2.2), and (21.0 ± 3.1) dBHL, respectively; The air bone conduction differences were (10.1 ± 2.7), (10.5 ± 2.8), (5.1 ± 0.3), and (10.0 ± 2.4) dBHL, respectively. The differences in air conduction between the two groups before and after treatment (1 month after treatment) were statistically significant (P&lt;0.05); The difference in air bone conduction between the two groups before and after treatment (1 month after treatment) was statistically significant (P&lt;0.05); However, there was no statistically significant difference in air bone conduction difference between the control group before and after treatment (P&gt;0.05). The incidence of PHN in the treatment group was lower than that in the control group, and the difference was statistically significant (P&lt;0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P&gt;0.05). Conclusion The external application of scorzonera glabra Herpes Ointment has a significant effect on treating HZE, and can shorten the course of the disease, improve hearing, restore the function of the auditory nerve, and effectively prevent PHN.