Rate Of Adverse Reactions Research Articles

Efficacy and Safety of Bortezomib or Thalidomide Combined with rhEPO in the Treatment of Multiple Myeloma

To explore the efficacy and safety of bortezomib or thalidomide combined with recombinant human erythropoietin (rhEPO) in the treatment of multiple myeloma (MM). A total of 80 patients with MM who were treated in the Second People's Hospital of Wuhu from January 2013 to December 2018 were selected as the research subjects, and they were divided into bortezomib group (n=40) and thalidomide group (n=40) by the simple randomization method. The bortezomib group received bortezomib regimen combined with rhEPO therapy, and the thalidomide group was given thalidomide regimen combined with rhEPO therapy, and all patients were treated for 3 courses with every 3 weeks as a course of treatment. The clinical efficacy after 3 courses of treatment, and tumor-related biochemical indicators [lactate dehydrogenase (LDH), β2-microglobulin (β2-MG), vascular endothelial growth factor (VEGF), apoptosis inhibitory protein Survivin], bone marrow-related indicators [serum M-protein, bone marrow plasma cells, hemoglobin (Hb)] and coagulation function indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), plasminogen activator inhibitor (PAI), total circulating microparticles (TMPs)] before treatment and after 3 courses of treatment were compared between the two groups of patients. The occurrence of adverse reactions during the treatment in the two groups of patients was recorded. After 3 courses of treatment, the ORR rate of 92.5% in bortezomib group was higher than 90.0% in thalidomide group, but the difference was not statistically significant (P >0.05). The levels of LDH, β2-MG, VEGF, Survivin, serum M-protein, bone marrow plasma cells, APTT, PT, PAI and TMPs in the two groups after 3 courses of treatment were significantly lower or shorter than those before treatment, and the above indicators in bortezomib group were significantly lower or shorter than those in thalidomide group (P <0.05). After 3 courses of treatment, the expression level of Hb in the two groups was significantly higher than that before treatment, and the Hb level in bortezomib group was significantly higher than that in thalidomide group (P <0.05). During the treatment process, the incidence rates of adverse reactions in bortezomib group were significantly lower than those in thalidomide group (P <0.05). Thalidomide regimen or bortezomib regimen combined with rhEPO has similar clinical efficacy on MM, but bortezomib regimen combined with rhEPO is more prominent and safer on improving tumor-related biochemical indicators, bone marrow-related indicators and coagulation status in patients with MM.

Real-World Multi-Food Home Oral Immunotherapy Using Daily Micro-Dose Schedules Has Low Rates of Adverse Reactions

Real-World Multi-Food Home Oral Immunotherapy Using Daily Micro-Dose Schedules Has Low Rates of Adverse Reactions

Is the Fast Track Safe? A Safety Evaluation of the COVID-19 Drugs with Real-World Data.

The US FDA has given emergency use authorization to multiple Covid-19 drugs. We conducted disproportionality analysis to detect adverse reaction rates (ADRs) in the US FDA's Adverse Event Reporting System. We discovered not only severe ADRs but also unique ADRs and effectiveness that might be explained by pharmacokinetics. This shows that real-time safety reviews could be effective methods for comparing the safety and efficacy of fast-track authorized drugs.

Topical Clindamycin For Acne Vulgaris: Pharmacovigilance Safety Review and Retrospective Analysis of Gastrointestinal Events

Background: Clindamycin, a lincosamide antibiotic, was the 125th most prescribed medicine in the US in 2020. Topical formulations that combine clindamycin with benzoyl peroxide or a retinoid are commonly used for acne vulgaris (AV) treatment. While oral and topical clindamycin carry warnings/contraindications regarding the development of gastrointestinal (GI) adverse events (AEs), the real-world incidence of these AEs with topical clindamycin is unknown. The objective is to provide an overview of safety data for topical clindamycin when used for AV treatment.&#x0D; Methods: Safety data from published literature on PubMed® (case reports, clinical trials data, retrospective data), previously unpublished worldwide pharmacovigilance data (from January 1, 1900-December 31, 2022), and two unpublished retrospective cohort studies of US electronic medical records (EMR; January 1, 2011 to January 31, 2019) were reviewed, with a focus on inflammatory bowel disease (IBD) and GI AEs following topical clindamycin monotherapy or combination treatment&#x0D; Results: There have been only 4 published case reports of topical clindamycin-associated GI AEs, which were all published between the years 1981-1997. In 8 published pivotal phase 3 clinical trials of topical clindamycin monotherapy or combination treatment for AV, GI-related AEs were reported in 1.4% of clindamycin-treated participants (38/2,672; safety populations). According to the pharmacovigilance data, the rate of GI-related adverse drug reactions with topical clindamycin-containing products was 0.000045% (64/141,084,533). In 1 published retrospective report, there were 0 reports of colitis from the 1,124 patients estimated to have received topical clindamycin prescriptions in the years 1977-1980. In the first retrospective EMR study, results indicate that physicians prescribe topical clindamycin for AV treatment equally to patients with a history of IBD (19.0%; 98/515) or without (20.7%; 14,495/70,151). The second retrospective EMR study showed that among patients with AV and an initial prescription for topical clindamycin (monotherapy or combination; n=18,012), there were 3 (0.02%) incident cases of pseudomembranous colitis within 30 days; none of these cases had a history of IBD.&#x0D; Conclusions: A review of published case reports, clinical trials safety data, worldwide pharmacovigilance data, and retrospective US prescription data demonstrate that GI events—including colitis or pseudomembranous colitis—in patients exposed to topical clindamycin is extremely low, regardless of IBD history.&#x0D; Support: Ortho Dermatologics

Safety and tolerability of intravenous immunoglobulin infusion in Down syndrome regression disorder.

Three large multi-center studies have identified the clinical utility of intravenous immunoglobulin (IVIg) in the treatment of Down syndrome regression disorder (DSRD). Yet the tolerability of infusions in individuals with DS and the safety of IVIg remains unknown in this population. This study sought to evaluate the safety and tolerability of IVIg in individuals with DSRD compared to a real-world cohort of individuals with pediatric onset neuroimmunologic disorders. A single-center, retrospective chart review evaluating clinically documented infusion reactions was performed for individuals meeting international consensus criteria for DSRD and having IVIg infusions between 2019 and 2023. Infusion reactions were evaluated for severity and need for alterations in infusion plan. This cohort was compared against an age and sex matched cohort of children with neuroimmunologic conditions who had also received IVIg infusions. In total, 127 individuals with DSRD and 186 individuals with other neuroimmunologic disorders were enrolled. There was no difference in the overall rate of adverse reactions (AEs) between the DSRD and general neuroimmunology cohorts (p = 0.31, 95% CI: 0.80-2.00), but cardiac-related AEs specifically were more common among the DSRD group (p = 0.02, 95% CI: 1.23-17.54). When AEs did occur, there was no difference in frequency of pharmacologic intervention (p = 0.12, 95% CI: 0.34-1.13) or discontinuation of therapy (p = 0.74, 95% CI: 0.06-7.44). There was a higher incidence of lab abnormalities on IVIG among the general neuroimmunology cohort (p = 0.03, 95% CI: 0.24-0.94) compared to the DSRD cohort. Transaminitis was the most common laboratory abnormality in the DSRD group. In a large cohort of individuals with DSRD, there were no significant differences in the safety and tolerability of IVIg compared to a cohort of children and young adults with neuroimmunologic conditions.

Time to major adverse drug reactions and its predictors among children on antiretroviral treatment at northwest Amhara selected public hospitals northwest; Ethiopia, 2023.

Adverse drug reaction is one of the emerging challenges in antiretroviral treatment. Determining the incidence rate and predictors among children on antiretroviral treatment (ART) is essential to improve treatment outcomes and minimize harm. And also, evidence regarding the time to major adverse drug reactions and its predictors among children on antiretroviral treatment is limited in Ethiopia. This study aimed to assess the time to major adverse drug reaction and its predictors among children on antiretroviral treatment at selected public hospitals in Northwest Amhara, Ethiopia, 2023. A retrospective cohort study was conducted among 380 children on antiretroviral treatment who enrolled from June 27, 2017, to May 31, 2022. Data was collected using a structured data extraction checklist. Data were entered into Epidata 4.6 and analyzed using STATA 14. The incidence rate of major adverse drug reactions was determined per person/months. The Cox proportional hazards regression model was used to identify predictors of major adverse drug responses. A p-value less than 0.05 with a 95% CI was used to declare statistical significance. The minimum and maximum follow-up time was 6 and 59 months, respectively. The study participants were followed for a total of 9916 person-months. The incidence rate of major adverse drug reactions was 3.5 /1000 person-months. Advanced clinical stages of HIV/AIDS (III and IV) [adjusted hazard ratio = 7.3, 95% CI: 2.74-19.60)], poor treatment adherence [adjusted hazard ratio = 0.33, 95% CI: 0.21-0.42], taking antiretroviral treatment twice and more [adjusted hazard ratio = 3.43, 955 CI: (1.26-9.33)] and not taking opportunistic infection prophylaxis [adjusted hazard ratio = 0.35, 95% CI: 0.23-0.52)] were predictors of major adverse drug reactions. The incidence rate of major adverse drug reactions among children on antiretroviral treatment was congruent with studies in Ethiopia. Advanced clinical stages of HIV/AIDS, poor treatment adherence, taking antiretroviral treatment medications twice or more, and not taking opportunistic infection prophylaxis were predictors of major adverse drug reactions.

Fondaparinux Results in Similar Pregnancy Outcomes with Lower Adverse Reaction Rates Compared to Low Molecular Weight Heparin in Chinese Recurrent Miscarriage Women.

Fondaparinux inhibits thrombin generation by inactivating factor Xa, which has the potential to treat recurrent miscarriage (RM). However, more clinical evidence is required to support its application in Chinese women with RM. This research aimed to compare the live birth rate, gestational weeks at delivery, birth weight, Apgar score of newborns, and adverse reaction rates between fondaparinux and low molecular weight heparin (LMWH) in Chinese women with RM. Totally, 132 women with RM treated with fondaparinux or LMWH were included in this retrospective study. According to the corresponding treatment, women with RM were divided into the fondaparinux cohort (N = 45) and LMWH cohort (N = 87). The live birth rate was 68.9% in the fondaparinux cohort and 56.3% in the LMWH cohort, which was not different between the two cohorts (P = 0.161). Multivariable logistics regression analysis suggested that only previous miscarriage times (≥ 4 times vs. < 4 times) were independently related to a lower possibility of live birth in women with RM (odds ratio = 0.431, P = 0.036). It was also observed that gestational weeks at delivery (38.1 ± 1.4 vs. 37.7 ± 1.7 weeks) (P = 0.258), birth weight (2,923.7 ± 355.0 vs. 2,807.8 ± 334.0 g) (P = 0.144), and Apgar score of newborns (9.8 ± 0.5 vs. 9.6 ± 0.8) (P = 0.175) were not different between the fondaparinux cohort and LMWH cohort. Inspiringly, the total adverse reaction rate was reduced in the fondaparinux cohort vs. the LMWH cohort (20.0% vs. 37.9%) (P = 0.036). Fondaparinux results in similar pregnancy outcomes with lower adverse reaction rates compared to LMWH in Chinese women with RM.

Effects of western medicine and Huangqi Taizishen Chenpi decoction on the treatment of severe pneumonia in children

To investigate the effects of Western medicine and Huangqi Taizishen Chenpi decoction on treating severe pneumonia in children. This study involved 100 children diagnosed with severe pneumonia and treated at our hospital from January 2021 to September 2023. They were randomly assigned into two groups: an experimental group (n = 50; received Huangqi Taizishen Chenpi decoction, a traditional Chinese medicine formulation) and a control group (n = 50; received conventional Western medical treatment). Then, the clinical outcomes between these two treatment modalities were compared. Among the 100 patients, 71 (71%) were infected by a single pathogen, with respiratory syncytial virus, rhinovirus and Pseudomonas aeruginosa being the most common pathogens identified. The experimental group exhibited a significantly higher overall effective treatment rate (98%) compared to the control group (84%) (p &lt; 0.05). Additionally, the experimental group had significantly shorter hospital stays (11.30 ± 1.59 days), quicker resolution of lung rales (5.60 ± 1.70 days), and faster symptom improvement times (8.50 ± 1.91 days) than the control group (14.60 ± 2.08 days, 7.80 ± 2.33 days, 10.70 ± 2.13 days respectively) (p &lt; 0.05). Post-treatment lung function tests, including Forced Vital Capacity (FVC) (2.76 ± 0.50 L), Maximum Mid-Expiratory Flow (MMF)(1.83 ± 0.56 L/s), and Forced Expiratory Volume in 1 second (FEV1) (2.25 ± 0.46 L), were significantly improved in the experimental group compared to the control group (2.41 ± 0.40 L, 1.43 ± 0.43 L/s, 1.87 ± 0.35 L respectively) (p &lt; 0.05). The rate of adverse reactions in the experimental group was significantly lower (6%) compared to the control group (16%) (p &lt; 0.05). Huangqi Taizishen Chenpi decoction significantly improves treatment outcomes in children with severe pneumonia, reduces the recovery period, and enhances the restoration of bodily functions with fewer adverse reactions, thereby demonstrating promising clinical significance.

Clinical efficacy and safety of secukinumab in the treatment of generalized pustular psoriasis in the pediatric population: a systematic review of the literature.

Generalized pustular psoriasis (GPP) is a severe type of psoriasis. The current treatment primarily relies on corticosteroids and immunosuppressants. In recent years, biologics have been increasingly utilized in the treatment of this disease, and have demonstrated good clinical efficacy. However, children and adolescents are primarily treated with immunosuppressants, which have limited clinical application due to the serious side effects they may cause. At the same time, the effectiveness of current treatments is unsatisfactory. Secukinumab has been widely reported to be effective and safe in treating this disease. However, there are still insufficient data on its use in treating GPP in children. To conduct a systematic review of the existing literature on the use of secukinumab for treating generalized pustular psoriasis in children and adolescents, and to evaluate its clinical effectiveness and safety. We conducted a systematic review of all the literature reporting on the treatment of GPP in children and adolescents with secukinumab. A total of 7 papers (46 patients) were included in this study. After 12 weeks of treatment, all 46 participants were able to achieve a GPPASI score of 90 or higher, with approximately 96% of patients achieving complete clearing of the lesions (GPPASI 100 or JDA0). Adverse events were reported in 8 patients, the rate of adverse reactions was approximately 17%. The treatment of GPP in children and adolescents with secukinumab has a rapid onset of action and a high safety profile. However, the results of the literature may be influenced by publication bias.

Transdermal buprenorphine patch as an adjunct to multimodal analgesia after total joint arthroplasty: a retrospective cohort study.

Total hip arthroplasty or total knee arthroplasty (THA/TKA) is often associated with varying degrees of pain. In recent years, transdermal buprenorphine (TDB) patch has shown encouraging results for acute postoperative pain control in orthopedic surgery. The aim of our study was to investigate the efficacy and safety of the combination of TDB patch and nonsteroidal anti-inflammatory drugs (NSAIDs) as a multimodal analgesic regimen after THA/TKA. Patients who underwent THA and TKA between January 2022 and January 2023 were reviewed. Three postoperative analgesic regimens were selected: Group A (flurbiprofen 50mg and tramadol 37.5mg/acetaminophen 325mg), Group B (flurbiprofen 50mg and TDB 5mg), and Group C (Parecoxib 40mg and TDB 5mg). The primary outcomes were the Wong-Baker face pain scale revision (FPS-R) scores and the rate of sleep disturbances. Secondary outcomes of the study included the proportion of patients with postoperative pain relief rates categorized as 0%, <50%, ≥50%, and 100%. The dynamic FPS-R pain scores on day 3 after surgery in Group B were significantly lower than those in Group A for THA (P < 0.017). The dynamic FPS-R pain scores were lowest in Group C on day 2 and 3 after THA and TKA (P < 0.017). Rate of sleep disturbances was significantly lower in Group B for THA and in Group C for TKA, respectively, compared with that in Group A (P < 0.017). The proportion of dynamic pain relief rate ≥50% in Group C was statistically higher than that in Group A for THA (P < 0.017). Rate of adverse reactions among three groups for THA and TKA was not statistically different (P > 0.05). This study suggests that the combination of TDB patch and NSAIDs is safe and effective for postoperative analgesia after THA/TKA.

Comparison between effects of mini-implant anchorage and face-bow anchorage in orthodontics for children.

To study the values of mini-implant anchorage in orthodontics for children in the mixed dentition stage, 78 children in the mixed dentition stage who had accepted orthodontic treatment in our hospital from January 2020 to January 2021 were enrolled into this study. All children were treated with straight-wire appliance. According to their anchorages, children were divided into observation group and control group based on the random number table. Children in the control group used face-bow to control the anchorages and children in the observation group used mini-implants to control the anchorages. After treatment, the upper central incisor convex distance difference, inclination angle of the upper central incisor, displacement of the molar, gingival health, masticatory function, treatment effect and adverse reaction rate of children in two groups were compared. One year after treatment, compared with children in the control group, children in the observation group had smaller the upper central incisor convex distance difference, inclination angle of the upper central incisor, displacement of the molar, small scores of plaque index (PLI), bleeding index (BI) and gingival index (GI), stronger biting force and higher masticatory efficiency, lower adverse reaction rate during treatment, better treatment effect, higher satisfaction of orthodontic treatment. And differences of all the above indexes were statistically significant (p < 0.05). Mini-implant anchorages have good stability and directive force, and have certain values in orthodontics for children in the mixed dentition stage.

Effects of TCM external scalding therapy on spleen-stomach deficiency cold stomachache and inflammatory indexes.

To determine the efficacy and safety of traditional Chinese medicine (TCM) external scalding therapy on spleen-stomach deficiency cold stomachache. The medical records of 98 patients with spleen-stomach deficiency cold stomachache treated in the Affiliated Hospital of Jiangnan University from January 2019 to January 2020 were collected and analyzed retrospectively. Among them, 52 patients treated with western medicine were assigned to the control group, while the other 46 patients treated additionally with TCM external scalding therapy were assigned to the observation group. The two groups were compared in terms of serum gastrin (GAS), inflammatory factors and visual analogue scale (VAS) score, adverse reaction rate and symptom remission time. After treatment, the observation group showed a significantly lower GAS level than the control group (P<0.05), along with significantly lower serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) than the control group (all P<0.05). The observation group demonstrated significantly lower VAS score than the control group (P<0.05). The observation group experienced notably shorter remission time of dull epigastric pain, epigastric distension, fatigue and belching and acid reflux than the control group (all P<0.05), and a significantly lower incidence of adverse reactions was found in the observation group than that in the control group (P<0.05). Multivariate analysis revealed that history of alcoholism and treatment method were independent risk factors affecting patient outcomes (all P<0.05). TCM external scalding therapy has shown effectiveness in treating spleen-stomach deficiency cold stomachache. It alleviates stomachache symptoms and also reduces the occurrence of adverse reactions and inflammation, holding great potential for widespread adoption in clinical practice.

Prevalence of Sputnik V COVID-19 Vaccine Side Effects Among Healthcare Workers in a Tertiary Care, Academic Center in Tehran City, Iran

Background and Purpose: COVID-19 vaccine side effects predominantly affect public confidence in vaccination. Therefore, this study evaluated the rate and severity of adverse reactions associated with the COVID-19 Sputnik V vaccine among tertiary healthcare providers in an academic medical center. Materials and Methods: This retrospective observational study was carried out from March 2021 to August 2021 among Imam Khomeini Hospital Complex healthcare workers, a tertiary referral healthcare center affiliated with Tehran University of Medical Sciences. Participants provided demographic and clinical information through a validated questionnaire after being interviewed. The frequency, severity, and outcome of all reactions after vaccination were recorded. The study utilized SPSS software, version 24.0 to conduct descriptive statistics on baseline variables and inferential statistics to examine associations between vaccine side effects and gender, medical history, and COVID-19 history of the participants. Additionally, ordinal regression analysis was employed to identify factors predicting the severity of adverse effects after the first and second doses of the Sputnik V vaccine. Results: A total of 372 participants (54.3% female) with a mean age of 36.5±9.18 years were recruited. The rate of at least one side effect was 77.15% and 57.8% after the first and second doses, respectively. The most common side effects among participants were myalgia (48.4% after the first and 28.2% after the second dose), injection site pain (26.3% after the first and 12.6% after the second dose), and fever (19.6% after the first and 12.9% after the second dose). The higher rate of fever and myalgia after the first dose was observed among subjects with a history of COVID-19. Conclusion: Among healthcare workers, the side effects following the first and second doses of the Sputnik V vaccine were primarily mild, with no cases requiring hospitalization. Further research is required to assess potential side effects in larger and diverse populations with varying demographic and social characteristics.

Application of multi-disciplinary team nursing model enhances recovery after surgery for total hip arthroplasty and total knee arthroplasty.

To explore the effect of a multidisciplinary team (MDT) nursing model based on enhanced recovery after surgery (ERAS) in total hip arthroplasty (THA)/total knee arthroplasty (TKA) and evaluate its application in the perioperative period of patients. A retrospective analysis was conducted on 100 patients with THA/TKA treated at Shaoxing Second Hospital Medical Community General Hospital from January 2021 to December 2023. The patients were divided into an observation group (n = 50) and a control group (n = 50) based on the nursing method employed. The control group received traditional perioperative nursing, while the observation group received an MDT nursing model intervention based on the ERAS concept. Visual analogue scale (VAS) scores were recorded at 6, 24, and 72 hours post-surgery. Additionally, postoperative activities, hospitalization duration, and postoperative complications were documented. Differences in knee joint range of motion (ROM), hip Harris score, psychological stress response score, and quality of life score between the two groups before and one month after surgery were analyzed. At 6, 24, and 72 hours post-surgery, patients in the observation group had significantly lower VAS scores compared to those in the control group (all P < 0.05). The observation group had an earlier first-time mobilization (P < 0.05). The length of hospitalization and hospitalization cost were significantly lower in the observation group than in the control group (both P < 0.05). The incidence rates of postoperative adverse reactions were 22.00% in the control group and 6.00% in the observation group (P < 0.05). One month post-surgery, the observation group showed significantly greater ROM, lower psychological stress and reaction scores, and higher Harris score and quality of life score compared to the control group (all P < 0.05). The MDT nursing model based on ERAS concept for THA/TKA perioperative patients effectively alleviates postoperative pain, promotes early activity, shortens hospital stay, reduces hospital cost, decreases the incidence of complications, restores joint function, enhances quality of life, and reduces psychological stress.

Effects and safety of Ophiocordyceps sinensis preparation in the adjuvant treatment for dialysis patients: a systematic review and meta-analysis.

Ophiocordyceps sinensis (O. sinensis), a genus of ascomycete fungi, has been widedly used in China as a dietary supplement or natural remedy and intensively studied in various disease models with its immunomodulatory potentials. It is a rich source of various bioactive compounds and used for treating end-stage renal disease. This systematic review with clinical evidence aimed to highlight the efficacy and safety of O. Sinensis as an adjuvant treatment for patients undergoing dialysis. A systematic search through nine electronic databases up to 31 April 2024, was conducted for related studies. The Cochrane risk-of-bias tool was used to evaluate the quality of studies. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the certainty of evidence. Two researchers independently searched the literature and evaluated the risk of bias. After the screening, 35 randomized controlled trials (RCTs) involving 2,914 patients were eventually included. The meta-analysis showed that using O. sinensis effectively reduced the following outcomes in patients undergoing dialysis: C-reactive protein (15RCTs, MD = -2.22, 95% CI -3.24 to -1.20; very low certainty evidence); creatinine (22RCTs, MD =1.33, 95% CI -1.79 to -0.87; very low certainty evidence); blood urea nitrogen (21RCTs, MD = -1.57, 95% CI -2.07 to -1.07; low certainty evidence);. It could also effectively improve the following outcomes in patients undergoing dialysis: albumin (20RCTs, MD = -0.81, 95% CI -1.21 to -0.41; low certainty evidence); hemoglobin (19RCTs, MD = -1.00, 95% CI -1.43 to -0.57; low certainty evidence). The rate of adverse drug reactions was higher in the control group than in the experimental group (4RCTs, MD = 1.81, 95% CI 0.88-3.74). The current evidence indicates that patients with dialysis receiving O. sinensis in the adjuvant treatment may improve nutritional and micro-inflammatory status and renal function for both hemodialysis and peritoneal dialysis patients. However, some limitation affected the generalizability of our findings. High-quality studies evaluating mortality outcomes of patients with different dialytic modalities in CKD are warranted in future. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324508, registration number CRD42022324508.

Efficacy and Mechanism of Alprostadil in Diabetes Mellitus Combined with Peripheral Atherosclerosis.

The aim is to investigate the clinical efficacy of Alprostadil in diabetes mellitus (DM) combined with peripheral atherosclerosis and to investigate the molecular mechanisms. Patients included 154 cases with DM combined with peripheral atherosclerosis and were divided into the conventional group (77 cases) and the Alprostadil group (77 cases). Both groups of patients were given conventional treatment, and the Alprostadil group was given Alprostadil treatment on the basis of the conventional group. The therapeutic efficacy and clinical symptom improvement were compared, and the adverse reactions were observed. An in vitro cell model was constructed using high glucose (HG) (50 mM) and oxidized low-density lipoprotein (50 μg/mL) treatment. The total effective rate of treatment in the Alprostadil group was higher than that in the conventional group. The biochemical indices of whole blood viscosity, plasma viscosity, erythrocyte pressure volume, and fibrinogen, as well as the level of inflammatory factors in the Alprostadil group were lower than those in the conventional group. The incidence rate of adverse reactions of Alprostadil administration was lower than that in the conventional group (P = .030). Alprostadil inhibited platelet aggregation and promoted platelet spreading. Alprostadil had an ameliorative effect on HG- and oxidized low-density lipoprotein cholesterol (ox-LDL)-induced human umbilical vascular endothelial cells (HUVECs), and promoted apoptosis and inflammatory response of HUVECs. Clinically, the use of Alprostadil as an adjunct to conventional therapy for the treatment of DM combined with peripheral atherosclerosis has high clinical efficacy. In addition, Alprostadil has a significant ameliorative effect on high glucose- and ox-LDL-induced HUVECs.

Effects of sufentanil in combination with dexmedetomidine for patient-controlled intravenous analgesia after renal transplantation

Background/Aim. Nowadays, the most convenient analgesic method is patient-controlled intravenous injection of one or more adjuvant drugs. The aim of our study was to evaluate the effects of sufentanil plus dexmedetomidine for patient-controlled intravenous analgesia (PCIA) after renal transplantation. Methods. Seventy-eight patients receiving living-related renal transplantation under general anesthesia were selected. Radioisotope scanning was performed, and the single glomerular filtration rate of the unilateral kidney was ? 40 mL/min/1.73 m2. The control group (CG) and observation group (OG) (39 patients in each group) were analgesic with sufentanil and sufentanil plus dexmedetomidine, respectively. When the Visual Analogue Scale (VAS) score exceeded 4 points, 0.05 mg/kg oxycodone was intravenously injected for remedial analgesia. Plasma levels of endothelin, urea nitrogen, and creatinine were measured by radioimmunoassay. Heart rate (HR), mean arterial pressure, oxygen saturation, VAS score, and sedation score were recorded before anesthesia and after surgery. Analgesic remediation rate, number of effectively pressing the PCIA pump, and incidence rate of adverse reactions within 48 hrs after surgery were recorded. Results. HR of OG was significantly lower than that of CG 6 and 12 hrs after surgery (p &lt; 0.05). VAS score of OG was lower than that of CG 6, 12, and 24 hrs after surgery (p &lt; 0.05). OG had a lower postoperative remedial rate, number of effectively pressing the PCIA pump, and incidence rates of nausea and vomiting (p &lt; 0.05) compared to CG. Endothelin, urea nitrogen, and creatinine levels significantly decreased after surgery compared with those before anesthesia (p &lt; 0.05). The levels of OG were lower than those of CG at each time point after surgery (p &lt; 0.05). Conclusion. Sufentanil plus dexmedetomidine can be safely and effectively used for PCIA after renal transplantation, with superior outcomes to those of sufentanil alone.

Influence of propranolol plus methimazole on curative efficacy and thyroid function of patients with hyperthyroidism.

To analyze the influence of propranolol (Prop) plus methimazole (MMI) on curative efficacy and thyroid function (TF) of patients with hyperthyroidism (HT). In this retrospective study, 107 cases of HT presented between August 2019 and August 2021 were grouped according to different therapeutic regimens: a control group (the Con) with 53 cases treated with MMI, and a research group (the Res) with 54 cases treated with Prop + MMI. Inter-group comparisons were performed in terms of the following domains: heart rate (HR), efficacy, adverse reactions (ARs), TF parameters (free triiodothyronine, FT3; free thyroxine, FT4; thyroid stimulating hormone, TSH), hepatic function indicators (alanine aminotransferase, ALT; aspartate aminotransferase, AST), and quality of life (Short-Form 36 Item Health Survey, SF-36). Finally, multivariate analysis was performed by Logistic regression to determine the risk factors leading to the ineffectiveness of treatment. The analysis showed an obviously higher total effective rate and an evidently lower AR rate in the Res compared with the Con group. Besides, the Res group had notably lower FT3, FT4, ALT and AST and statistically higher TSH after treatment compared with the baseline (before treatment) and the Con group. Higher SF-36 scores were also determined in the Res group. Finally, the results of Logistic regression analysis revealed that AST was an independent risk factor for ineffective treatment. Prop plus MMI is effective in the treatment of HT, which can effectively improve the HR, thyroid hormone levels, hepatic function, and quality of life of patients, with a lower incidence of ARs.

Comprehensive Analysis of Factors Influencing Endometrial Polyps Incidence and Evaluation of Hysteroscopy Treatment Efficacy

Objective: To analyze the factors related to the incidence of endometrial polyps and assess the value of hysteroscopic treatment. Methods: Fifty women with endometrial polyps admitted to the gynecology department of Xinghua People’s Hospital between January 2020 and June 2021 participated in the study. They were categorized into two groups using numerical expressions, and their uteri were analyzed. Causes and related factors of endometrial polyps were assessed. The study included 25 patients undergoing dilation and curettage (control group) and 25 patients undergoing hysteroscopy (observation group). Clinical surgical indicators, endometrial indicators, adverse reactions, and recurrence rates were compared between the two groups. Results: The observation group exhibited lower intraoperative and postoperative bleeding volumes, as well as significantly shorter operation time and hospitalization time compared to the control group (P &lt; 0.05). The incidence rate of adverse reactions was 4.0% in the observation group, significantly lower than the 24.0% in the control group (P &lt; 0.05). After 1 year of follow-up, the recurrence rate in the observation group was 4.0%, considerably lower than the 20.0% in the control group (P &lt; 0.05). Conclusion: Endometrial polyps have various causes, including endometritis and long-term use of contraceptive pills use. Hysteroscopic treatment proves effective, with minimal adverse reactions and a low recurrence rate, making it a commendable surgical option for promotion.

Effect of Magnesium Sulfate Combined with Labetalol in the Treatment of Pregnancy-Induced Hypertension and Its Impact on Adverse Pregnancy Outcomes

Objective: To investigate the effect of magnesium sulfate combined with labetalol in treating hypertension in pregnancy (HIP) and its impact on adverse pregnancy outcomes. Methods: A total of 150 HIP patients treated at the Qujing Maternal and Child Healthcare Hospital from June 2020 to June 2023 were randomly assigned using the lottery method. They were divided into the control group (treated with magnesium sulfate alone, 75 cases), and the intervention group (magnesium sulfate + labetalol combined treatment, 75 cases). Blood pressure levels, total adverse reaction rates, total adverse pregnancy outcome rates, and total adverse fetal outcome rates were compared between the two groups. Results: Compared to the control group’s diastolic (87.94 ± 4.86 mmHg) and systolic (138.52 ± 9.23 mmHg) blood pressures, the intervention group showed lower levels of diastolic (78.95 ± 3.57 mmHg) and systolic (129.88 ± 7.47 mmHg) blood pressures (P &lt; 0.05). The intervention group exhibited a lower total adverse reaction rate (4.00%) compared to the control group (14.67%; P &lt; 0.05). Similarly, the total adverse pregnancy outcome rate in the intervention group (4.00%) was significantly lower than that in the control group (18.67%; P &lt; 0.05). Furthermore, the total adverse fetal outcome rate in the intervention group (6.67%) was lower than that in the control group (22.67%; P &lt; 0.05). Conclusion: The combination of magnesium sulfate and labetalol demonstrates significant efficacy in treating HIP. It effectively lowers blood pressure, improves pregnancy and fetal outcomes, is highly safe, and deserves promotion and application.