PCM Group Research Articles

Identification of Flavonoids by LC-MS/MS in Leaves Extract From Protium heptaphyllum(Aubl.) March and Antioxidant Activity in Mice

Background: Protium heptaphyllum (Aubl.) March resin is accepted as an analgesic, healing, expectorant, anti-inflammatory, antinociceptive and gastroprotective agent. However, there are no specific studies on leaves of this plant. Objective: This study identified the chemical composition and biological activity of crude ethanolic extract (EE) and ethyl acetate (EA) fraction from P. heptaphyllum. Methods: Mice were intoxicated with acetaminophen (PCM; 250 mg kg-1), and subsequently treated with EE and EA (100 mg kg-1) for 7 days via gavage. Plasma analysis and evaluation of liver and kidney homogenates of the animals were performed. Results: The extract and fraction showed the presence of phenols and flavonoids. Three main flavonoids were identified by HPLC-UV, LC-MS/MS fractionation, quercetin-3-β-D-glycoside, myricetin and quercetin. For total antioxidant potential tests, EE presented EC50 of 75 mg kg-1 and 100 μg mL-1 for EA. ALT, AST and ALP enzymes activity increased in the PCM-exposed plasma, but EA decreased these activities at control levels for ALT and AST. Animal glycemic levels decreased with EE and EA, which may be due to a possible hypoglycemic effect of the plant. In the liver tissue, SOD was unchanged, CAT, GSH and ASA decreased in the PCM group, but EA was able to reverse these effects. TBARS and PC were reduced by both treatments. In the renal tissue, EA fraction recovered the GST activity, GSH levels were restored by EE and EA and PC was reduced by treatments. Conclusion: This antioxidant effect may be due to the presence of the flavonoids identified, which are already well known for their antioxidant properties.

Roles of Suaeda vermiculata Aqueous-Ethanolic Extract, Its Subsequent Fractions, and the Isolated Compounds in Hepatoprotection against Paracetamol-Induced Toxicity as Compared to Silymarin.

Suaeda vermiculata, a halophyte consumed by livestock, is also used by Bedouins to manage liver disorders. The aqueous-ethanolic extract of S. vermiculata, its subsequent fractions, and pure compounds, i.e., pheophytin-A (1), isorhamnetin-3-O-rutinoside (2), and quercetin (3), were evaluated for their hepatoprotective efficacy. The male mice were daily fed with either silymarin, plant aq.-ethanolic extract, fractions, pure isolated compounds, or carboxyl methylcellulose (CMC) for 7 days (n = 6/group, p.o.). On the day 7th of the administrations, all, except the intact animal groups, were induced with hepatotoxicity using paracetamol (PCM, 300 mg/kg). The anesthetized animals were euthanized after 24 h; blood and liver tissues were collected and analysed. The serum aspartate transaminase (AST) and alanine transaminase (ALT) levels decreased significantly for all the S. vermiculata aq.-ethanolic extract, fraction, and compound-treated groups when equated with the PCM group (p < 0.0001). The antioxidant, superoxide dismutase (SOD), increased significantly (p < 0.05) for the silymarin-, n-hexane-, and quercetin-fed groups. Similarly, the catalase (CAT) enzyme level significantly increased for all the groups, except for the compound 2-treated group as compared to the CMC group. Also, the glutathione reductase (GR) levels were significantly increased for the n-butanol treated group than for the PCM group. The oxidative stress biomarkers, lipid peroxide (LP) and nitric oxide (NO), the inflammatory markers, IL-6 and TNF-α, and the kidney's functional biomarker parameters remained unchanged and did not differ significantly for the treated groups in comparison to the PCM-induced toxicity bearing animals. All the treated groups demonstrated significant decreases in cholesterol levels as compared to the PCM group, indicating hepatoprotective and antioxidant effects. The quercetin-treated group demonstrated significant improvement in triglyceride level. The S. vermiculata aq.-ethanolic extract, fractions, and the isolated compounds demonstrated their hepatoprotective and antioxidant effects, confirming the claimed traditional use of the herb as a liver protectant.

Effect of restorative timing on shear bond strength of composite resin/calcium silicate-based cements adhesive interfaces.

The aim of this study was to evaluate the shear bond strength inherent to immediate and delayed definitive composite resin restorations, over three different biomaterials. Fifty-four aluminum blocks were randomly assigned to six experimental groups(n = 9) according to the biomaterial (Biodentine, TotalFill BC Putty, or PCM) and restoration timing (immediate or 7 days delayed). Regarding the restorative procedures, a two-step self-etch bonding system (Clearfil SE Bond) was applied and subsequently restored using a flowable composite resin (SDR). After shear bond strength testing, fracture pattern analysis was performed. The significance level was set at α = 0.05. Within the immediate groups, Biodentine showed the highest mean shear bond strength value, with no statistically significant differences (P > 0.05) being detected when compared with both TotalFill (P = 0.072) and PCM (P = 0.232) groups. Regarding the delayed restoration groups, Biodentine and TotalFill presented the highest mean shear bond strength value, with statistical differences when compared with PCM (P = 0.002 and P = 0.043, respectively). No statistically significant differences (P > 0.05) were verified between both immediate and delayed groups for each tested biomaterial. Also, a statistically significant association was found between the fracture type and the biomaterial (P < 0.001). Our findings suggest that all tested biomaterials present suitable alternatives which allow to perform restorative procedures immediately after pulp capping biomaterial placement (3 or 12 min, depending on the bioactive cement), therefore requiring one single appointment to complete the procedure. Biodentine and TotalFill BC Putty have shown superior shear bond strength results when compared with PCM, within a delayed timeframe (7 days).

Postoperative Outcomes and Complications in Hallux Rigidus: A Comparison Between Polyvinyl Alcohol Implant and Cheilectomy with Moberg Osteotomy

Category:Midfoot/Forefoot; OtherIntroduction/Purpose:In 2016, the US Food and Drug Administration (FDA) approved the use of a polvinvyl alcohol (PVA) hydrogel implant (Cartiva, Elmsford, NY) for surgical treatment of hallux rigidus, or degenerative arthritis of the first metatarsophalangeal (1st MTP) joint. While studies have demonstrated the safety and usability of PVA implant, clinical outcomes following hemiarthroplasty with the PVA have not yet been compared to that of traditional joint-preserving procedures such as cheilectomy with Moberg osteotomy in the treatment of hallux rigidus. The purpose of this study is to compare patient-reported outcomes and postoperative complications between PVA hemiarthroplasty and cheilectomy with Moberg osteotomy, with the hypothesis that the addition of PVA would result in superior clinical outcomes.Methods:Patients were retrospectively identified who underwent hallux rigidus correction by one of seven Foot and Ankle fellowship-trained orthopaedic surgeons between March 2016 and November 2018. Out of 162 patients, a total of 133 patients constituted our study cohort after excluding patients with insufficient follow-up. Of the 133, 60 patients (mean age 57.2 years) were treated with combination PVA, cheilectomy, and Moberg osteotomy (PCM) and 73 patients (mean age 54.1) were treated with cheilectomy and Moberg (CM) alone. Both preoperative as well as minimum 1-year postoperative patient-reported outcome scores (PROMIS) were compared between the two cohorts. Chart review was performed to compare rates of revision and complications.Results:Average time to follow-up was 14.5 months for PCM and 15.6 for CM groups. Both PCM and CM cohorts demonstrated significant improvement in PROMIS scores, with the CM group demonstrating significantly greater increase in Physical Function (7.14 +- 8.48 vs 3.58 +- 6.24, p=0.01). While preoperative scores were comparable, postoperatively the CM group had a significantly higher average Physical Function (51.8 +- 8.7 vs 48.8 +- 8.0, p=0.04) and lower Pain Intensity (39.9 +- 8.3 vs 43.4 +- 8.7, p=0.02). There were 2 cases of revision with re-implantation and 1 case of conversion to arthrodesis in the PCM group. There was 1 case of conversion to PVA in the CM group. Three patients who underwent PCM had a documented postoperative infection requiring antibiotics.Conclusion:Our data suggests that the addition of polyvinyl alcohol implant in the treatment of hallux rigidus results in significant improvement in patient-reported outcomes. However, patient-reported physical function may not be up to par at minimum 1-year follow-up compared to cheilectomy and Moberg osteotomy alone. In addition, while incidence was low in our cohort, revision of the implant as well as conversion to arthrodesis remain possible complications of PVA. Therefore, we believe that proper patient selection is recommended when considering surgical treatment options for hallux rigidus.

The expression and meaning of CD68, CD163, CD57, and IgG4 in granulomatous lobular mastitis.

The exact etiology and pathogenesis of granulomatous lobular mastitis (GLM) are yet to be illuminated. This study aimed to investigate CD68, CD163-positive M2 macrophages, CD57-positive natural killer (NK) cells, and IgG4 in GLM lesion tissue to explore their correlation with the occurrence and clinical features of GLM. Surgical pathologic specimens of GLM were collected from patients admitted to Hunan Provincial People's Hospital between October, 2014 and October 2015. Based on the postoperative pathological diagnosis, the tissues were divided into 3 groups: the experimental group (GLM, n=36), control group 1 (plasma cell mastitis, PCM, n=17), and control group 2 (breast cystic hyperplasia, n=10). Immunohistochemical staining was carried out using Elivision super testing to detect CD68, CD163, CD57, and IgG4 expression in the pathological tissue samples. The relationship between clinical parameters, including age, reproductive condition, nipple retraction, and tumor size, and the expressions of CD68, CD163, CD57, and IgG4 was analyzed. There was no obvious difference in the levels of CD68, CD163, and CD57 expression between the GLM group and the PCM group, although both groups had higher expression levels of expression than the breast cystic hyperplasia group (P<0.05). In the GLM group, the expression level of CD57 at 2 weeks-3 months was significantly higher than at ≤2 weeks (P<0.05). The expression level of CD57 in PCM patients >2 years after lactation was significantly higher than in patients ≤2 years after lactation (P<0.05). The level of IgG4 expression in GLM patients with nipple retraction was significantly higher than in those without nipple retraction (P<0.05). Inflammatory cells are closely linked to the occurrence of GLM and PCM. In our study, both the GLM and PCM groups had low expression of IgG4, but the expression level of IgG4 in GLM patients with inverted nipples was significantly higher than that in patients without inverted nipples. This suggests that there may be two different clinical subtypes of GLM. Furthermore, our research also found that NK cells can provide a basis for GLM clinical staging.

Comparison of Fascia Iliaca Block with Intravenous Paracetamol, as Postoperative Analgesic Method for Femur Surgery

Background: Postoperative pain is extremely unpleasant which causes severe discomfort to the patient as well as it increases the anxiety, hospital stay so overall total burden. Objectives: Comparison of efficacy between fascia iliaca block with intravenous paracetamol, as postoperative analgesic method after femur surgery. Simultaneously requirement of other analgesics in the first 24 hours.Subjects and Methods:Prospective longitudinal study conducted in patients belonging to age group of 18 to 65 years posted for femur surgeries. All patients were received Intrathecal injection of 3.5 ml of 0.5% hyperbaric bupivacaine and divided into two groups. After completion of surgery Group I received the Fascia Iliaca block with thirty ml of 0.25% of injection bupivacaine and Group II received injection Paracetamol one gram intravenously. Duration of analgesia, time from block / iv PCM to 1st rescue analgesia, number of patients as well as total doses of required rescue analgesics in 1st 24 hours were observed postoperatively.Results:From One hour onwards at all the time interval, mean pain scores was less in FIB group as compared to PCM group(p&lt;0.001). In FIB group 15 (42%) patients had more than 24 hours and 11(32%) patients had 12-24 hours of analgesia, where as in PCM Group not a single patient had more than 12 hours of analgesia. In FIB group only 20 (57%) patients required rescue analgesic as compared to 35 (100%) patients in PCM group.Conclusion:In FIB insertion point is away from femoral vessels and can be provided without nerve stimulator. Post-operative it is extremely crucial to provide analgesia specially initial 24 hours. FIB can provide prolong duration of analgesia, so helps in early mobilization and early rehabilitation as well as it also reduces opioid requirements. Thus, Fascia iliaca block is an effective, easy and affordable method for postoperative analgesia and can be used safely as a part of multimodal approach to pain relief after femur surgery.

Effectiveness of local MSC derived from placenta and their conditioned medium in local radiation burn

Background & Aim To study the effect of mesenchymal stem cells (MSC) derived from placenta human and their conditioned medium concentrate on skin regenerative processes in laboratory animals with local radiation burn (LRB). Methods, Results & Conclusion The study used 80 laboratory animals (males Wistar aged 8-12 weeks and weighing of 210.0±30,0 g), randomized into 4 groups (20 animals each): control (C) - without therapy; control with the injection of the concentrate of the culture medium (CM); injection of MSC (P); the injection of the PCM. The dose of therapy was of 2 million cells per 1 kg three times at on the 1, 14 and 21 days after radiation exposure. Histological and immunohistochemical (CD31, CD68, VEGF, PGP9.5, Ki67, FVIII, collagen I and III, TIMP2, MMP 2 and 9) studies were performed. LRB was modeled on an x-ray unit at a dose of 110 Gy. MSC were cultured according to standard methods 3-5 passage, carried out fence of the conditioned medium and concentrated it in 10 times. An the LRB was recorded in all groups of animals on day 14 of the experiment. The LRB in the PCM group was less than 6.7 times compared with the control group. Complete healing of the skin was observed on the 112th day in the PCM group in 60%, in the SM group in 40%, in the P group in 20%, and in the C group there were no animals. Histological studies showed a decrease in inflammatory processes, the presence of primordia of hair follicles, and proliferation of microvasculature in the PCM group, in contrast to other groups in which these changes were not so noticeable. In all groups, the regenerative potential of cells in the LRB is reduced, which is confirmed by immunohistochemical data. An increase in the expression of MMP 2 and 9, TIMP 2, collagen I and III, and the number of CD68 macrophages was observed in the PCM group on the 112th day, which probably indicates an increase in the rate of scarring and healing of the wound surface. Thus, the use of the PCM in severe LRB in laboratory animals accelerates the transition of the wound process to the stage of regeneration and epithelization. It is interesting that in one of the control groups, when using a CM, a significant decrease in the area of the wound was observed in comparison with other groups throughout the observation period. However, the analysis of histological and immunohistochemical studies does not allow to state definitely about the effectiveness of this type of therapy. To study the effect of mesenchymal stem cells (MSC) derived from placenta human and their conditioned medium concentrate on skin regenerative processes in laboratory animals with local radiation burn (LRB). The study used 80 laboratory animals (males Wistar aged 8-12 weeks and weighing of 210.0±30,0 g), randomized into 4 groups (20 animals each): control (C) - without therapy; control with the injection of the concentrate of the culture medium (CM); injection of MSC (P); the injection of the PCM. The dose of therapy was of 2 million cells per 1 kg three times at on the 1, 14 and 21 days after radiation exposure. Histological and immunohistochemical (CD31, CD68, VEGF, PGP9.5, Ki67, FVIII, collagen I and III, TIMP2, MMP 2 and 9) studies were performed. LRB was modeled on an x-ray unit at a dose of 110 Gy. MSC were cultured according to standard methods 3-5 passage, carried out fence of the conditioned medium and concentrated it in 10 times.

Paracetamol vs Ibuprofen in Hemodynamically Significant Patent Ductus Arteriosus (HsPDA) in Preterms: A Randomized Controlled Trial

Background and Objective: Hemodynamically significant patent ductus arteriosus (HsPDA) is a common cause of morbidity in preterm infants. Indomethacin and Ibuprofen, which are cyclo-oxygenase (COX) 1, 2 inhibitors are commonly used drugs for closure of HsPDA. As, Ibuprofen has several contraindications, we designed study using oral paracetamol (a peroxidase inhibitor) and compared with oral ibuprofen, for efficacy and safety in relation to closure of HsPDA in preterm infants.&#x0D; Methods: 140 preterm infants (gestational age less than 32 weeks) with HsPDA (confirmed by 2D Echo) were randomly assigned in two groups and received first course of either oral paracetamol (70) or ibuprofen (70). The need for a second course was determined by 2D Echo evaluation. Parameters studied were rate of ductal closure, any adverse effects and discharge rate.&#x0D; Results: Both groups were similar in term of ductal closure after first course (p=0.46) and second course (p=0.59). However, 22 from Ibuprofen group and only 2 from PCM group developed adverse effects (p&lt;0.001). From paracetamol group 58 were discharged, and 12 died; while from ibuprofen group 46 discharged, 24 died (p=0.03).&#x0D; Conclusion: Paracetamol for HsPDA in preterm neonates was associated with good efficacy and better safety; and less deaths, as compared to ibuprofen.

Efecto de un programa de educación física regular y cuentos motores en la aptitud física y desarrollo motor de escolares costarricenses

Se determinaron cambios en la Resistencia Cardiovascular [RCV], Fuerza del Extensor del Tronco [FET] y Destrezas Fundamentales de Movimiento [DFM] en niños, luego de recibir un Programa de Educación Física Regular [PEFR]; o, un Programa de Cuentos Motores [PCM]; y, comprobando diferencias entre Actividad Física Moderada y Vigorosa [AFMV]. 55 estudiantes completaron el estudio, distribuidos en tres grupos PEFR, PCM y Grupo Control (GC). Los grupos recibieron 20 clases no el GC. Se contabilizó el tiempo de AFMV mediante POLAR®. Se utilizó FITNESSGRAM® y TGMD-2® para medir variables. La RCV y FET en grupos intervenidos mejoró. Las DFM en ambos grupos intervenidos mejoró. A pesar de que los sujetos mantuvieron un Coeficiente de Desarrollo Motor Grueso (CDMG) bajo; los programas coadyuvaron a su mejoría, no así el GC que conservó un CDMG muy pobre. El PCM y el PEFR fueron eficaces para generar cambios en aptitud física y destrezas analizadas.

Development and implementation of a comprehensive psychosocial screening program in a Brazilian cancer center.

International guidelines recommend routine screening for distress as part of care practices. Accordingly, a Brazilian cancer center developed and implemented a distress screening program (DS) in 2007, which was enhanced in 2009 through the inclusion of a psychosocial care meeting group (DS+PCM) regarding patients' psychosocial needs. The current paper will provide an overview of the development and pilot implementation of this program and initial analyses to assess patient outcomes and report initial results to extend international research on this key aspect of cancer care. Patients were assessed for distress, anxiety and depression, and in the DS+PCM phase for quality of life at the first day of chemotherapy infusion, at midpoint, and at treatment end. We compared data from program phases (DS vs DS+PCM), with a sequential cohort design and mixed effects modeling. Clinical and demographic characteristics were similar between groups. Patients receiving DS+PCM showed significantly lower distress and depression/anxiety upon chemotherapy initiation (Ps<.001). While both groups reported significantly lowered distress and total depression/anxiety scores across time (Ps<.003), patients receiving DS+PCM maintained the lowest distress and total anxiety/depression at all assessments. Patients from DS+PCM group also reported improvements in quality of life over time. The current study provides preliminary evidence that a multidisciplinary structured screening program utilizing validated measures and team meetings is associated with reduced impairment in patients' psychological well being. This program provided more opportunities for collaboration among providers with increased multidisciplinary meetings, enabled patients to more easily report problems, and ensured rapid access to relevant resources.

Effects of feed processing and forms of dietary methionine on growth and IGF-1 expression in Jian carp

In this study, a practical basal diet (control, C) was supplemented with crystal methionine (Met) (CM) or encapsulated Met (EM), and then was pelleted (P) or extruded (E) to form six diets, PC, PCM, PEM, EC, ECM and EEM. The six diets were fed to Jian carp with initial body of 8.6 ± 0.4 g for 8 weeks to evaluate the effects of Met supplementation and feed processing on growth of the fish. In pelleted diets, weight gain (WG) increased and feed conversion ratio (FCR) decreased (P < 0.05) in response to the supplementation of EM, but both WG and FCR were not affected by the supplementation of CM in the pelleted diet, when compared with PC group. In extruded diets, WG of fish fed ECM or EEM diets was higher and FCR was lower (P < 0.05) than those of fish fed EC diet. In the pelleted diets, the highest level of serum free Met was observed at the 1st, 2nd and 3rd h after feeding for PCM, PEM and PC group, respectively, but the three extruded diet groups showed the same peaking time at the 3rd h after feeding. In both pelleted and extruded diets, the supplementation of EM increased the expression of IGF-1 gene in muscle (P < 0.05) when compared to PC and EC respectively. Results above indicated that the growth of Jian carp can be improved by the supplementation of EM in pelleted diet, or by the supplementation of EM, CM in extruded diet deficient in Met, but not by the supplementation of CM in pelleted diet.

Niveles locales de marcadores de inflamación en fluido crevicular gingival en diabéticos tipo 2 de recién diagnóstico con periodontitis crónica

El sistema inmune del sujeto diabético sufre alteraciones debido a la enfermedad, repercutiendo en los tejidos periodontales. El objetivo fue evaluar los marcadores de inflamación de interleucina (IL)-2, IL-6 e IL-8 en fluido crevicular gingival de pacientes con diabetes mellitus tipo 2 (DMT2). Los participantes se agruparon en cuatro grupos: 1) sanos (n = 20), 2) con periodontitis (PCM, n = 20), 3) con diabetes ≤1 año y periodontitis (DMT2≤1+PCM, n = 20) y 4) con diabetes de ≥10 años con periodontitis (DMT2≥10+PCM, n = 20). Los marcadores se cuantificaron por citometría de flujo. Como resultado, el grupo de DMT2≥10+PCM mostró niveles mayores de IL-2 con relación a los demás grupos, al igual que niveles elevados de IL-6 con respecto del PCM. Los niveles de IL-8 resultaron mayores en el grupo de sanos frente a los demás grupos. Se concluye que los sujetos con DMT2≥10+PCM mostraron una respuesta inmune adaptativa-destructiva del tejido periodontal en comparación con DMT2≤1+PCM que muestran una alteración inmunológica.

X-Ray-based Kinematic Analysis of Cervical Spine According to Prosthesis Designs

A retrospective study. To identify significant kinematic changes in the cervical spine after cervical artificial disk replacement (ADR) using prostheses with diverse designs. Various types of artificial disks are used for cervical ADR. However, few clinical studies with a follow-up of 2 or more years have reported on the change in the curvatures and range of motion (ROM) of the cervical spine after cervical ADR in relation to different designs. The cohort comprised 58 patients who underwent single-level cervical ADR for radiculopathy. The patients were divided into 4 groups according to the device they received: Mobi-C, Bryan, PCM, and Prestige LP. The radiographs of the cervical spine were obtained preoperatively and at 12, 24, and 36 months after surgery. Several kinematic parameters, including lordotic angles and ROM of the cervical spine, index level, and superior and inferior adjacent disk levels, were assessed preoperatively and at predefined follow-up time points. Cervical sagittal lordosis in patients who received Bryan and PCM prostheses increased at the last follow-up period. The 4 patient groups showed a trend toward an increase of lordosis in the superior adjacent segment with time. The patients who received the Bryan device lost their preoperative lordotic angle at the inferior adjacent level. The ROM of the cervical spine in patients who received Bryan and PCM prostheses increased at the last follow-up compared with preoperative values. The incidence of adjacent segment degeneration in the Mobi-C, Bryan, Prestige LP, and PCM groups were 14.2%, 25%, 9.0%, and 7.6%, respectively. These results suggest preservation of sagittal ROM and increased superior adjacent segment kinematics, regardless of prosthesis design. Devices with an unconstrained design may not be beneficial to adjacent segment kinematics compared with semiconstrained prostheses.

6-months follow-up retrospective study of posterior total (NISSEN) fundoplication patients with GERD: Influence of psychiatric co-morbidity and antidepressant co-treatment in therapeutic result outcomes

Background: Surgical methods play a significant role in the treatment of gastroesophageal reflux disease (GERD) refractory to conservative therapy. There is no evidence-based consensus on the best choice of technique, posterior total (360o) Nissen fundoplication is the most widely used antireflux surgery technique worldwide. Therapy dependent and refractory GERD patients with psychiatric co-morbidity and/or antidepressant co-treatment araise challange in choice of best treatment methods. Aim of the study was to compare 6-month-results of Nissen fundoplication of psychiatric co-morbidity (PCM, n = 16) and antidepressant co-treatment (ADT, n = 17) as independent risk factors with general population data in our patients (n = 177) between 2011 – 2015. Results: Postoperative improvement of GERD symptoms occured in 86% (symptom-free ratio was 48.6%), in antidepressant treated group 88.2% (and 41%, respectively) and in case of psychiatric co-morbidity 56.2% (and 31.2%, respectively). Reoperation was needed in 2.82% of patiens (none in PCM or ADT group). Postoperative dysphagia occured in 28.8% (50% with PCM, 29% with ADT). Significant (> 10%) weight loss was measured 6 months after surgery in 24.8% (37.5% with PCM, 17.6% with ADT). Generally intervention because of surgery-associated comlication was needed in 10.2% (18.75% with PCM, 5.9% with ADT). Re-use of proton pump inhibitor (PPI) treatment was needed in 32.8% (62.5% with PCM, 35.3% with ADT) 6 month later. Conclusions: Similar to literature data psychiatric co-morbidity in itself worsens therapeutic results of Nissen fundoplication in objectively diagnosed therapy refractory and dependent GERD patients. However antidepressant use in itself does not seem to be a significant risk factor for it, it may decrease weight loss and some complication risk. More randomized data are needed to clear correlations in the matter.

The effect of prophylactic antipyretic administration on post-vaccination adverse reactions and antibody response in children: a systematic review.

BackgroundProphylactic antipyretic administration decreases the post-vaccination adverse reactions. Recent study finds that they may also decrease the antibody responses to several vaccine antigens. This systematic review aimed to assess the evidence for a relationship between prophylactic antipyretic administration, post-vaccination adverse events, and antibody response in children.MethodsA systematic search of major databases including MEDLINE and EMBASE was carried out till March 2014. Randomized controlled trials (RCTs) comparing prophylactic antipyretic treatment versus placebo post-vaccination in children ≤6 years of age were included. Two reviewers independently applied eligibility criteria, assessed the studies for methodological quality, and extracted data [PROSPERO registration: CRD42014009717].ResultsOf 2579 citations retrieved, a total of 13 RCTs including 5077 children were included in the review. Prophylactic antipyretic administration significantly reduced the febrile reactions (≥38.0°C) after primary and booster vaccinations. Though there were statistically significant differences in the antibody responses between the two groups, the prophylactic PCM group had what would be considered protective levels of antibodies to all of the antigens given after the primary and booster vaccinations. No significant difference in the nasopharyngeal carriage rates (short-term and long-term) of H. influenzae or S. pneumoniae serotypes was found between the prophylactic and no prophylactic PCM group. There was a significant reduction in the local and systemic symptoms after primary, but not booster vaccinations.ConclusionsThough prophylactic antipyretic administration leads to relief of the local and systemic symptoms after primary vaccinations, there is a reduction in antibody responses to some vaccine antigens without any effect on the nasopharyngeal carriage rates of S. pneumoniae & H. influenza serotypes. Future trials and surveillance programs should also aim at assessing the effectiveness of programs where prophylactic administration of PCM is given. The timing of administration of antipyretics should be discussed with the parents after explaining the benefits & risks.

A Prospective, Randomized, Controlled Clinical Investigation Comparing PCM Cervical Disc Arthroplasty With Anterior Cervical Discectomy and Fusion

Prospective, multicenter, randomized Food and Drug Administration approved investigational device exemption clinical trial. To evaluate the safety and effectiveness of the PCM Cervical Disc compared with anterior cervical discectomy and fusion (ACDF) in the treatment of patients with degenerative spondylosis and neurological symptoms at 1 level between C3-C4 and C7-T1. Cervical disc arthroplasty in the treatment of symptomatic cervical spondylosis has been studied in other series. The PCM Cervical Disc is a nonconstrained motion-sparing alternative to ACDF. Patients 18 to 65 years of age with single-level symptomatic cervical spondylosis with radiculopathy and/or myelopathy unresponsive to nonoperative treatment were enrolled, including patients with prior nonadjacent or adjacent single-level fusions. The per-protocol patient sample at 2 years included 342 patients (189 PCM, 153 ACDF). Longitudinal outcomes were comparatively evaluated. At 2 years postoperatively, clinical measures-neck and arm pain visual analogue scale, Neck Disability Index (NDI), SF-36, and neurological status-were significantly improved from preoperative baselines in both groups. Mean NDI score at 2 years was significantly lower in PCM group (P = 0.029). There were no statistical differences between groups in rates of surgery-related serious adverse events (5.6% PCM, 7.4% ACDF) or secondary surgical procedures (5.2% PCM, 5.4% ACDF). Patients with PCM reported lower dysphagia scores (8.8/100 vs. 12.1/100; P = 0.045) and higher patient satisfaction (82.8/100 vs. 81.4/100). Overall success, a composite endpoint including minimum 20% NDI improvement, no major complications, no neurological worsening, no secondary surgical procedures, and meeting radiographical criteria of motion for PCM and fusion for ACDF, was significantly greater in the PCM group (75.1% vs. 64.9%; P = 0.020). The treatment of symptomatic single-level cervical spondylosis with PCM achieves clinical outcomes that are at least equivalent to ACDF while maintaining motion. At 2 years, patients with PCM had lower NDI scores, statistically lower rate of prolonged dysphagia, greater patient satisfaction, and superior overall success.

An analysis of heterotopic ossification in cervical disc arthroplasty: a novel morphologic classification of an ossified mass

Background contextAlthough the precise cause of heterotopic ossification (HO) remains unclear, it is certain that it increases with time. The reason why the reported occurrence rate has been given as a wider range is that there were no clinical reports that have addressed the occurrence rate based on the morphology and position. PurposeThe aim of this retrospective study was to determine whether radiological parameters had an influence on the formation of HO and to compare the results after cervical arthroplasty using Bryan (Medtronic Sofamor Danek, Memphis, TN, USA), PCM (Cervitech, Rockaway, NJ, USA), and Prestige LP (Medtronic Sofamor Danek) implants. Study design/settingA retrospective study. Patient sampleEighty-one patients were included. Outcome measurementThe occurrence of HO was determined at the four corners of the disc space according to the McAfee classification system. Heterotopic ossifications were classified into Type 1, Type 2, and Type 3 HOs (end plate, traction spur, and teardrop types) based on their morphologic features. The presence of preoperative ossifications, sex, type of device, operated level, hybrid implantation, depth behind the prosthesis, cervical lordotic angle, and segmental angle between the footplates of the prosthesis were assessed as predictors in terms of location and morphologic features. MethodsEighty-one patients after 95 cervical arthroplasties using the Bryan (35 segments), PCM (30 segments), and Prestige LP implants (30 segments) underwent postoperative radiographs or three-dimensional computed tomography with a mean follow-up period of 46, 39, and 30 months, respectively, after the operation. ResultsThe overall incidence of all cases and one-level subgroup were 64.2% and 60.3%, respectively. According to the types of device, the incidence of HO was 49% (Bryan), 80% (PCM), and 60% (Prestige). Type 1 HO (62.1%) was found only in the posterosuperior disc space. Type 2 HO (13.7%) was primarily detected in the anterosuperior disc space rather than the posterosuperior disc space (3.2%). Type 3 HO (4.2%) developed only in the anterior disc space. In the anterior disc space, the incidence of Type 2 and Type 3 HOs was highest in the PCM group. In the posterior disc space, the Bryan group showed a lower proportion in the high McAfee class than the other device groups. The occurrence of Type 1 HO in the posterosuperior disc space was significantly related with the presence of preoperative ossification (p=.030), ossification in the ligamentum nuchae (p=.027), male sex (p=.042), and PCM device (p=.012). A well-fitting (p<.002) and less lordotic segmental angle (p<.015) were correlated with Type 1 HO. Implantation in the upper cervical level (p=.016) and hybrid implantation with cage (p=.033) or artificial disc (p=.048) on the upper adjacent level were significant risk factors for anterior Type 2 HO. Cervical lordotic angle at 1 month after surgery had a significant connection with the occurrence of anterior Type 2 HO in both groups of all cases (p=.032) and one-level subgroup (p=.000). ConclusionsType 1 HO developed mostly in the posterior disc space. Type 2 HO was the dominant type in the anterior disc space. Type 3 HO developed only in the anterior disc space. It is certain that both Type 1 and Type 2 HOs are related to biomechanical stresses (compressive force for Type 1 HO and traction force for Type 2 HO). It is suggested that a cervical arthroplasty should be selected in terms of the implant level, hybrid conditions on the upper adjacent segment, disc design vulnerable to the pseudotranslation, the presence of preoperative ossification, and fitting implants to end plates to reduce the development of HO.

Synthesis and determination of acute and chronic pain activities of 1-[1-(4-methylphenyl)(cyclohexyl)] morpholine as a new phencyclidine derivative in rats

Phencyclidine (1-(1-phenylcyclohexyl)piperidine, CAS 77-10-1, PCP, I) and many of its analogues have been synthesized and their pharmacological properties studied. In this research, new methyl morpholine derivative of phencyclidine (1-[1-(4-methylphenyl) (cyclohexyl)]morpholine, Methyl-PCM, III) was synthesized and the acute and chronic pain activities were studied using tail immersion and formalin tests on rats and compared to PCP and PCM (1-(1-phenylcyclohexyl)morpholine, CAS 2201-40-3, PCP-morpholine, II). The results Indicated that Methyl-PCM (III, 6 mg/kg, i.p) produces more analgesic effects in tail immersion test (as a model of acute thermal pain) in comparison with the PCP, PCM and control groups. Meanwhile, this analgesic effect was markedly shown 5-15 min after the compound III application. In formalin test analysis, the acute pain (phase I) could not be affected by any drugs, but the chronic formalin pain (phase II) could be diminished by PCM and especially compound III. The chronic analgesic effect of Methyl-PCM was markedly shown in the late phase of chronic pain.

Phenol Chemical Matricectomy Is Less Painful, with Shorter Recovery Times but Higher Recurrence Rates, Than Surgical Matricectomy: A Patient's View

Ingrown toenails have a tendency for recurrence. Operative interventions can be successful, and several procedures are in use. Retrospective evaluation, to reveal differences in postoperative pain, time to recovery, and satisfaction with the cosmetic outcome in patients treated with a phenol (PCM) or surgical matricectomy (SM). All matricectomy patients at the Dermatology Department of the Ludwigshafen City Hospital between 2004 and 2008 were interviewed over the telephone. Of 72 evaluable patients with a total of 112 ingrown nail sides, 33 were treated with PCM and 39 with SM. The patient group consisted of 40.3% women, the median age was 31. Patients after PCM indicated two points less postoperative pain on an analogue scale from 0 to 10 (p<.001). In the PCM group, more patients recovered from the operation in less than 1 week (p=.007). Patient evaluation of cosmetic outcome was not different between the groups (p=.76), but recurrence rates were significantly higher in the PCM group (31.5%, vs 6.9% in the SM group, p=.006) Both matricectomies have advantages and disadvantages. We should discuss these issues with our patients to help them decide on the kind of matricectomy.

A multicenter study of Chinese patent medicine wenweishu/yangweishu in the treatment of Helicobacter pylori positive patients with chronic gastritis and peptic ulcer

To evaluate the efficacy of Chinese patent medicine wenweishu /yangweishu in the treatment of Helicobacter pylori (H. pylori) positive patients with chronic gastritis and peptic ulcer. A randomized, controlled and multicenter trial was conducted in 642 H. pylori positive patients with chronic gastritis or peptic ulcer. They were randomized to three groups: PCM group (n = 222, pantoprazole 40 mg twice a day, clarithromycin 500 mg twice a day, metronidazole 400 mg twice a day, for 7 days); PCM plus wenweishu group (n = 196); and PCM plus yangweishu group (n = 224). (14)C breath test was performed 4 weeks after therapy. For the patients with gastric ulcer, ulcer healing was determined by endoscopy after therapy. Intention-to-treat H. pylori eradication rate for PCM group, PCM plus wenweishu group, and PCM plus yangweishu group were 57.2% (127/222), 62.2% (122/196), 60.3% (135/224), respectively (P = 0.295, 0.512). Per-protocol H. pylori eradication rates were 62.3% (127/204), 70.1% (122/174), 65.2% (135/207), respectively (P = 0.108, 0.532).Per-protocol analysis gastric ulcer healing rate were 61.9% (13/21) 100.0% (18/18), 86.4% (19/22) respectively. The healing rate in PCM plus wenweishu groups was statistically significantly higher than the rate in PCM group (P = 0.004). The rates of symptom relief in PCM plus wenweishu groups and PCM plus yangweishu were statistically significantly higher than the rate in PCM group (both P < 0.01). Side-effects were rare and comparable between groups. Although PCM combined with wenweishu or yangweishu in the treatment of H. pylori positive patients with chronic gastritis and peptic ulcer can not reach a significantly higher eradication rate, it can increase the rates of both gastric ulcer healing and symptom relief.