Routine Treatment Research Articles

Analysis of Clinical Characteristics of Insomnia Patients and Effect of Acupuncture Therapy

Objective: To explore the clinical characteristics of insomnia patients and the function and mechanism of acupuncture therapy, to improve the recognition and diagnosis of insomnia. Methods: The clinical data of 60 patients with insomnia who met the criteria and were admitted to the Department of Acupuncture and moxibustion in Yunnan Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2023 to February 2024 were selected, the clinical characteristics of the patients were analyzed, and the patients were randomly divided into two groups for routine treatment and acupuncture treatment, respectively, to explore the therapeutic effect and possible mechanism. Results: The insomnia symptoms of the patients were mainly difficulty in falling asleep. Acupuncture treatment could significantly improve the insomnia symptoms and promote the expression levels of DA and NE. Conclusion: Patients with insomnia have various clinical features, mainly sleep difficulties. Acupuncture treatment can significantly relieve insomnia symptoms by up-regulating DA and NE levels, and then improve sleep quality.

Wearable, Biocompatible, and Dual-Emission Ocular Multisensor Patch for Continuous Profiling of Fluoroquinolone Antibiotics in Tears.

The abuse or misuse of antibiotics in clinical and agricultural settings severely endangers human health and ecosystems, which has raised profound concerns for public health worldwide. Trace detection and reliable discrimination of commonly used fluoroquinolone (FQ) antibiotics and their analogues have consequently become urgent to guide the rational use of antibiotic medicines and deliver efficient treatments for associated diseases. Herein, we report a wearable eye patch integrated with a quadruplex nanosensor chip for noninvasive detection and discrimination of primary FQ antibiotics in tears during routine eyedrop treatment. A set of dual-mode fluorescent nanoprobes of red- or green-emitting CdTe quantum dots integrated with lanthanide ions and a sensitizer, adenosine monophosphate, were constructed to provide an enhanced fluorescence up to 45-fold and nanomolar sensitivity toward major FQs owing to the aggregation-regulated antenna effect. The aggregation-driven, CdTe-Ln(III)-based microfluidic sensor chip is highly specific to FQ antibiotics against other non-FQ counterparts or biomolecular interfering species and is able to accurately discriminate nine types of FQ or non-FQ eyedrop suspensions using linear discriminant analysis. The prototyped wearable sensing detector has proven to be biocompatible and nontoxic to human tissues, which integrates the entire optical imaging modules into a miniaturized, smartphone-based platform for field use and reduces the overall assay time to ∼5 min. The practicability of the wearable eye patch was demonstrated through accurate quantification of antibiotics in a bactericidal event and the continuous profiling of FQ residues in tears after using a typical prescription antibiotic eyedrop. This technology provides a useful supplement to the toolbox for on-site and real-time examination and regulation of inappropriate daily drug use that might potentially lead to long-term antibiotic abuse and has great implications in advancing personal healthcare techniques for the regulation of daily medication therapy.

Minimally Invasive Sinus Tarsi Approach versus Extensile Lateral Approach for Sanders Type II & III Calcaneal Fractures (Systematic Review & Meta-analysis)

Abstract Background Open reduction and internal fixation (ORIF) is becoming more common in Calcaneal fractures of Sanders types II and III. The extensile lateral approach (ELA) appears to be the gold standard. Aim of the Work We aimed to compare the clinical outcomes of intra- articular calcaneus fractures treated with open reduction and internal fixation with via Extensile lateral approach (routine treatment) versus those via a sinus tarsi approach (minimally invasive treatment). Materials and Methods This systematic review conducted on 7 studies enrolled 734 patients with Sanders type II & III calcaneal fractures comparing he clinical outcomes of intra-articular calcaneus fractures treated with open reduction and internal fixation (ORIF) via Extensile lateral approach (routine treatment). The outcome measures considered: Postoperative wound complications, AOFAS score, Time to surgery, Surgical operative time, 24 hours Postoperative VAS score, Bohler's angle improvement, Gissane's angle improvement, Calcaneus width reduction, Recovery of calcaneus length, Length of hospital stay. Results Regarding postoperative wound complication, minimal invasive procedure significantly reduced the rate of wound complications other than open reduction. Concerning American Orthopedic Foot and Ankle Society score (AOFAS) score, there was no significant difference between ORIF and minimally invasive (MI) method. With reference to time to surgery, there was a significant difference between ORIF and minimally invasive (MI) method. As regard surgical operative time, MI had a significant reduction in operative time. According 24 hours Post operative VAS score, there was no significant difference between ORIF and minimally invasive (MI) method. Concerning Bohler's and Gissane's angles improvement, there was no significant difference between ORIF and minimally invasive (MI) method. With reference to calcaneus width reduction, there was no significant difference between ORIF and minimally invasive (MI) method. According recovery of calcaneus length, the current study showed no significant difference between ORIF and minimally invasive (MI) method. Concerning length of hospital stay, the ORIF consume more hospital stay than minimally invasive methods. Conclusion In contrast to ELA, minimal invasive procedure (STA) reduced the rate of wound complication. There was no significant difference between ELA and STA regarding the anatomical and functional outcome. The STA showed significant reduction in time to surgery and operative time.

Association Between Metabolic Syndrome and Health-Related Quality of Life in Older Adults: Findings from the IRanian Longitudinal Study on Ageing.

Objectives: There are some studies without consensus on the association between metabolic syndrome (MetS) and health-related quality of life (HRQoL) and few studies among elderly participants; therefore, the aim of this study is evaluating the association between MetS and HRQoL between elderly participants after adjusting for possible confounding factors. Methods: A cross-sectional analysis was conducted with the data from baseline phase of the IRanian Longitudinal Study on Ageing. The MetS diagnosis was conducted based on the National Cholesterol Education Program Adult Treatment Panel III guidelines. The participants were 3452 subjects aged ≥60 years with and without MetS. The Prospective Epidemiological Research Studies in Iran version of the SF-12 questionnaire was used to examine subjects' perspectives on their well-being and general health level. The association between MetS and HRQoL was evaluated through multivariable linear regression model after adjusting for possible covariates. Results: MetS independently had an inverse association with subscales of HRQoL including physical functioning, physical problems, general health, social functioning, and emotional problems, even after fully adjusting for studied confounding factors. An inverse association was also observed between MetS and both mental component summary and physical component summary in the fully adjusted model. Conclusion: Older adults with MetS had a relatively worse physical and mental HRQoL in comparison with individuals without MetS. Independent of any underlying factors, the inverse association of MetS with HRQoL emphasizes the necessity of routine screening and treatment of MetS in older populations.

Intravaginal probiotics before embryo transfer do not improve pregnancy rates in recurrent implantation failure cases: An RCT.

Considering the considerable influence of the vaginal microbiome on endometrial receptivity and embryo implantation, we hypothesized that cases of recurrent implantation failure (RIF) might benefit from the intravaginal probiotic administration. Evaluation of the effects of intravaginal probiotic administration before frozen embryo transfer (FET) on the rates of pregnancy and the status of vaginal lactobacillary flora in cases of RIF. This was a randomized, parallel-group, clinical trial conducted at an infertility clinic in Tehran, Iran between January 2021 and September 2022. A total of 166 reproductive-aged women with a history of unexplained RIF were randomly assigned to either the probiotic group or the control group (n = 83/each group). The probiotic group received intravaginal probiotics (LactoVagⓇ) daily for 2 wk from the second day of the menstrual cycle along with the routine treatment of FET. The control group received only the routine treatment of FET. The primary outcome was the chemical pregnancy rate, and the secondary outcomes were the clinical pregnancy rate and the status of vaginal lactobacillary flora. A total of 163 participants were included in the final analysis. The probiotic group had a slightly higher chemical pregnancy rate than the control group (39.02% vs. 33.33%), but the difference was not statistically significant (risk ratio: 1.71, 95% CI: 0.77-1.76; p = 0.449). The clinical pregnancy rate was also non-significantly higher in the probiotic group than the control group (37.80% vs. 33.33%; RR: 1.14, 95% CI: 0.76-1.74; p = 0.623). Intravaginal probiotic administration did not significantly improve the pregnancy rates in RIF cases undergoing FET. Further studies are needed to explore the optimal dose, duration, and timing of probiotic administration, as well as the mechanisms of action and the potential adverse effects of probiotics on the vaginal microbiome and the implantation process.

Efficacy and Hemorheology of Ginkgo biloba Extract (EGb 761) in the Treatment of Sudden Sensorineural Hearing Loss: A Retrospective Study.

This study aimed to analyze the therapeutic effect of Ginkgo biloba extract (EGb 761) on sudden sensorineural hearing loss (SSNHL) and its influence on hemorheology. The clinical data of patients diagnosed with SSNHL and admitted to the Wendeng Hospital of Traditional Chinese Orthopedics and Traumatology of Shandong Province from May 2020 to May 2023 were retrospectively analyzed. Based on different clinical treatment protocols, patients were divided into a control group (treated with routine treatment) and an administration group (treated with routine treatment + EGb 761). Both groups underwent drug treatment for 10 days. Subsequently, the hearing threshold, hemorheological parameters (blood high shear viscosity, blood low shear viscosity, plasma viscosity, and platelet aggregation rate) and inflammatory factors and serum levels (C-reactive protein, interleukin-6, tumor necrosis factor-α and soluble vascular cell adhesion molecule-1) of these groups were compared. This study comprised 120 patients, with 66 cases in the control group and 54 cases in the administration group. Following treatment, the total effective rate of the administration group was significantly higher than that of the control group (90.74% vs. 72.73%) (P-value < 0.05). The hearing threshold, hemorheological parameters, inflammatory factors, and serum levels were significantly lower in the administration group than in the control group (P-value < 0.05). Compared with routine treatment, joint EGb 761 in the SSNHL treatment may improve the hearing threshold and hemorheological indexes of patients, inhibit the inflammatory response, and promote the recovery of hearing function. Moreover, no serious adverse reactions are observed, indicating adequate safety.

Routine use of denosumab for prevention of skeletal-related events in patients with bone metastases from prostate carcinoma in Bulgaria: a prospective observational study

Bulgarian real-world data on denosumab use for the prevention of skeletal-related events (SREs) associated with bone metastases (BM) from prostate cancer (PC) are lacking. This observational study enrolled 100 adult PC patients with ≥1 BM receiving denosumab (EUPAS26983). Patients’ routine treatment was observed retrospectively for ≤6 months and prospectively for 12 months. Denosumab use and safety, SRE incidence, denosumab persistence (allowing ≤2 missed doses), and pain severity were evaluated using descriptive statistics. Denosumab was initiated at a median (Q1, Q3) of 1.8 (0.6, 9.6) months following BM diagnosis with earlier initiation in hormone-sensitive (HSPC; 1.5 [0.6; 4.2]; n = 74) than castration-resistant PC (CRPC; 7.9 [0.8; 16.4]; p = .082; n = 26) and in younger (<65 years; 1.2 [0.3; 2.8]; n = 19) than older patients (≥65 years; 2.0 [0.7; 9.6]; p = .161; n = 81). Ten SREs were recorded during the retrospective and 10 during the prospective period; none were symptomatic. Denosumab was used for a median of 472 (387, 599) days overall and for 443–464 days without missing more than two doses (persistence). The proportion of patients reporting acceptable pain (score ≤4 of 10) increased from 6% at baseline to 22% at month 12. Twenty-four denosumab-related adverse events were reported, 2 were serious (osteomyelitis, osteitis) and 5 were related to osteonecrosis of the jaw. In Bulgarian clinical practice, denosumab use was associated with the prevention of symptomatic SREs and pain improvement. Denosumab was mostly used persistently. No symptomatic SREs were reported. Safety findings were consistent with previous reports of denosumab use in PC.

Comparison of different doses of Tripterygium glycosides treating in IgA vasculitis nephritis: A Bayesian network meta-analysis

BackgroundTripterygium glycosides (TG) is extracted from the roots of Tripterygium wilfordii Hook F (Lei gong teng, a traditional Chinese medicine). It is widely used in China to treat immunoglobulin A vasculitis nephritis (IgAVN), which is a common secondary glomerular disease. As there are no guidelines for the rational application of TG, we performed this study to evaluate the efficacy and safety of different doses of TG and to determine the optimal treatment for IgAVN. MethodsTen databases were searched from their inception to April 2023 for randomised controlled trials (RCTs) using TG, TG combined with glucocorticoids (GC), or TG combined with traditional Chinese medicine (TCM) to treat IgAVN. A network meta-analysis was performed following the protocol (CRD42023401645). ResultsForty-four eligible RCTs involving 3402 patients were included. For effective rate, TG 1.5 mg/kg/d (TG1.5) + TCM was ranked as the best intervention, followed by TG 1.0 mg/kg/d (TG1.0) + TCM, TG1.5, TG1.0+GC, TG1.0, TCM, GC, and routine treatment (RT). TG1.0+TCM ranked best in reducing recurrence, followed by TG1.0+GC, GC, TG1.5, and RT. Compared with TG1.0, TG1.0+TCM and TG1.5+TCM effectively reduced liver injury events. Compared with TG1.5, TG1.5+TCM and TG1.0+TCM effectively reduced leukopenia events. No significant differences in the reduction of gastrointestinal events were observed between the interventions. Subgroup analyses explored the effects of the participants’ age. The intervention rankings of the outcomes generally remained consistent. Only a small difference was observed in gastrointestinal events. TCM was the best treatment for reducing gastrointestinal events in paediatric patients. ConclusionsThe results showed a positive correlation between dose and efficacy, whereas no relationship was found between dose and adverse events. TCM can boost the efficacy and reduce adverse events when combined with TG. In conclusion, we consider TG1.5+TCM as the best treatment for IgAVN. However, further research is required to confirm these findings.

Application Value of Music Therapy in Improving the Emotional State and Quality of Life of Hospitalized Patients with Breast Cancer: Retrospective Study.

This study aimed to apply music therapy as a clinical treatment for patients with breast cancer (BC) experiencing mild or moderate depression during hospitalization and observe any improvements in their depression and quality of life. A total of 102 patients who had mild-to-moderate depression, were diagnosed with BC, and were admitted to our hospital from October 2022 to October 2023 were selected as the subjects of a retrospective analysis. According to their participation in short-term music therapy, they were divided into a control group (routine nursing treatment n = 45) and an observation group (routine nursing treatment + music therapy n = 57). Self-rating depression (SDS) scale and functional assessment of cancer therapy-breast (FACT-B) scale Chinese version 4.0 scores and patient satisfaction after treatment were compared between the two groups. After treatment, the SDS scale scores and FACT-B scores of the observation group were significantly better than those of the control group (P < 0.001). The patient satisfaction in the observation group was higher than in the control group (P < 0.05). Music therapy is a highly safe method to improve the depression and quality of life of patients with BC. It also provides a simple and convenient nondrug clinical treatment with broad application prospects.

Prevalence and Distribution of Dental Caries among Iraqi People

Abstract Background: Dental caries is the most prevalent oral disease worldwide. It is still a public health problem, particularly in developing countries. Objectives: The aim of this study was to measure the occurrence of dental caries among patients attending dental school and to investigate the type of dental caries by age, sex, and geographic area. Materials and Methods: After obtaining an appropriate ethical approval, the occurrence and type of dental caries according to G.V. Black classification were recorded among all patients aged 16 years and over during routine dental treatment at the dental hospital, College of Dentistry, University of Babylon, Hillah city, Babil governorate. World Health Organization’ criteria were used to diagnose and detect dental caries. Results: The final sample size was 463 individuals distributed as 217 (46.87%) men and 246 (53.13%) women. Overall, 1851 carious lesions were noticed, in which class I (68%) represents the most prevalent type of dental caries in the study sample followed by class II (20%), then class III (6%), and the least prevalent types (3%) were class IV and class V. There was no significant difference regarding the effect of gender on different caries classes (P &gt; 0.05). However, a significant difference was recorded regarding the effect of area of residence on different caries classes (P &lt; 0.05). Conclusions: In this study, high percentage of class I lesions in comparison to other classes of Black’s classification was noticed among the examined patients. Women experienced more dental caries than men and the area of residency had a significant impact on caries experience.

Effects of Dialectical Behavior Therapy (DBT) Skills Training on Depression and Anxiety Disorders - A Pilot Study under Routine Care Conditions

Skills training as an integral part of dialectical behavioral therapy (DBT) is highly effective in the treatment of borderline personality disorder. Research interest is increasingly focused on the transdiagnostic effects of the skills training on depression and anxiety disorders. The present study examined the extent to which the findings of high-quality randomized controlled studies can be transferred to everyday treatment under routine care conditions. N=26 patients without personality disorders were treated in a day clinic over a period of eight weeks. In the control group, 11 patients received routine care treatment and in the experimental group 15 patients additionally received weekly skills training. Symptom distress, as well as emotion regulation and mindfulness were assessed longitudinally at three time points. Multilevel analyzes were used to examine whether there was an additive effect of the skills training. The experimental group was superior to the control group in all endpoints. The effect sizes were comparable to those from experimental research. Improvements in mindfulness were significantly correlated with reductions in symptom distress. The findings fit into previous research efforts and complement them with a naturalistic research perspective. The advantages and disadvantages of an experimental and naturalistic research perspective are discussed, and relevant limitations of the present study are highlighted. Skills training is an established, flexible, modular therapy program that is ideal for improving the adaptability of patients with different psychological diagnoses.

Evaluating Danish Breast Cancer Group locoregional radiotherapy guideline adherence in clinical treatment data 2008–2016: The DBCG RT Nation study

Background and purposeGuideline adherence in radiotherapy is crucial for maintaining treatment quality and consistency, particularly in non-trial patient settings where most treatments occur. The study aimed to assess the impact of guideline changes on treatment planning practices and compare manual registry data accuracy with treatment planning data. Materials and methodsThis study utilised the DBCG RT Nation cohort, a collection of breast cancer radiotherapy data in Denmark, to evaluate adherence to guidelines from 2008 to 2016. The cohort included 7448 high-risk breast cancer patients. National guideline changes included, fractionation, introduction of respiratory gating, irradiation of the internal mammary lymph nodes, use of the simultaneous integrated boost technique and inclusion of the Left Anterior Descending coronary artery in delineation practice. Methods for structure name mapping, laterality detection, detection of temporal changes in population mean lung volume, and dose evaluation were presented and applied. Manually registered treatment characteristic data was obtained from the Danish Breast Cancer Database for comparison. ResultsThe study found immediate and consistent adherence to guideline changes across Danish radiotherapy centres. Treatment practices before guideline implementation were documented and showed a variation among centres. Discrepancies between manual registry data and actual treatment planning data were as high as 10% for some measures. ConclusionNational guideline changes could be detected in the routine treatment data, with a high degree of compliance and short implementation time. Data extracted from treatment planning data files provides a more accurate and detailed characterisation of treatments and guideline adherence than medical register data.

Efficacy and cerebral mechanisms of acupuncture for chronic obstructive pulmonary disease: study protocol for a multicenter, randomized controlled neuroimaging trial.

Although acupuncture is recommended by chronic obstructive pulmonary disease (COPD) treatment guidelines owing to its effects on dyspnea, the underlying neurobiological mechanisms of these effects remain unclear. This study aims to evaluate the efficacy of acupuncture in patients with stable COPD and explore the possible involvement of specific brain regions. This is a prospective, multicenter, single-blind, randomized controlled trial. A total of 90 participants will be recruited from three centers and will be randomly assigned in a 1:1 ratio to undergo acupuncture at acupoints on the disease-affected meridian (DAM) or non-acupoints on the non-affected meridian (NAM), in addition to routine pharmacological treatments. All participants will undergo 30 min of acupuncture three times a week for 8 weeks and will be followed up for 12 months. The primary outcome will be the severity of dyspnea, as measured using the Borg Dyspnea Scale and a visual analog scale at rest and after exercise. The secondary outcomes will include the multidimensional profile of dyspnea using Dyspnea-12, the modified Medical Research Council Dyspnea Scale, and the COPD assessment test; quality of life assessments using St George's Respiratory Questionnaire and the Hospital Anxiety and Depression Scale; and additional measurements of exacerbation frequency, pulmonary function, and the 6-min walking distance. Magnetic resonance imaging (MRI) will be performed before and after exercise to explore the potential neurobiological mechanisms of exertional dyspnea. Anxiety and depression will be measured and analyzed for their correlation with the activation of specific brain areas involved in dyspnea. This randomized controlled trial aims to use a multidimensional evaluation of the efficacy of acupuncture in relieving dyspnea in patients with COPD in terms of emotion and quality of life and explore the neurobiological mechanisms underlying the effects of acupuncture on dyspnea from an imaging perspective. It is expected to provide strong evidence to support the use of acupuncture in relieving dyspnea in patients with COPD and those with aother diseases involving dyspnea. Additionally, it provides novel insights into the central mechanisms of acupuncture intervention and dyspnea. Chinese Clinical Trial Registry (https://www.chictr.org.cn/): ChiCTR2300071725.

Comparison of ozone therapy and routine medical treatment effect on disease severity and serum level changes of IL-33 in patients with remitting-relapsing multiple sclerosis: A parallelled randomised clinical trial

IntroductionIL-33 is an inflammatory cytokine involved in the pathogenesis of Multiple sclerosis (MS) as an autoimmune inflammatory disease. Ozone therapy has been shown to improve the symptoms of the disease in previous studies. Given the limitations of previous studies, we investigated the effect of adding ozone therapy to conventional medical treatment in remitting-relapsing multiple sclerosis (RR-MS) patients from the points of disease severity and blood levels of IL-33. MethodsThis clinical trial was performed on 66 RR-MS patients, among whom 55 finished the study. The patients were divided randomly into two groups; one group (intervention) received ozone therapy in addition to the routine medical treatment, and the other group (control) received only routine medical treatment. The level of IL-33 was measured by ELISA, and the severity of the disease was measured by an expanded disability status scale (EDSS) in all patients before and after the treatment. Finally, the relationship between the serum levels of IL-33 and EDSS score with the type of treatment was evaluated. The research project was registered at the International Center for the Registration of Clinical Trials in Iran (IRCT20171105037262N3). ResultsOur findings showed that the serum levels of IL-33 in the ozone plus medical-treated group significantly decreased compared to the medical-treated group (P<0.001). The EDSS score also decreased significantly in the ozone plus medical-treated group compared to the medical-treated group (P=0.019). ConclusionOzone therapy reduces the severity of RR-MS. Such an effect may be influenced by modifying IL-33 levels.

Walking or breathing: comparing the 6-minute walking distance test to the pulmonary function test for lung resection candidates.

Given the limited use of the 6-minute walking distance (6MWD) test as a replacement for standard tests in thoracic surgery, insufficient research exists on the prognostic value of this test, and further studies are necessary. This study aimed to investigate the correlation between pulmonary function tests (PFT) and the 6MWD test in lung resection patients. This cross-sectional study, conducted in 2021-2022, involved lung resection candidates referred to the thoracic surgery clinic. Demographic data, including age, sex, and body mass index (BMI), were collected, and pulmonary function tests and 6MWD tests were conducted for all patients. The sample size of the study was 31, and all patients received routine treatment during hospitalization. Of the 31 subjects included in the study, 16 were male (51.6%) and 15 (48.4%) were female. The mean age of the patients was 33.45±13.78 years. The median forced expiratory volume in one second (FEV1) and the mean ratio of FEV1/forced vital capacity (FVC) were 2.16 (1.49-2.85) liters and 81.80±7.34%, respectively. No significant correlation was found between the results of 6MWD and PFT, including FVC, FEV1, and FEV1/FVC ratio (P>0.05). The 6MWD test is a more economical and easily accessible test than PFT. However, this study found no correlation between the 6MWD test and spirometry parameters. Therefore, we suggest that surgeons should not rely on the 6MWD test as a predictive value for assessing respiratory function in lung resection candidates. The study's findings have important implications for clinical practice.

Pulmonary haemorrhage and haemoptysis associated with bevacizumab-related treatment regimens: a retrospective, pharmacovigilance study using the FAERS database.

Background: Bevacizumab (BV) is widely used in routine cancer treatment and clinical therapy in combination with many other agents. This study aims to describe and analyse post-market cases of pulmonary haemorrhage and haemoptysis reported with different BV treatment regimens by mining data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: Data were collected from the FAERS database between 2004 Q1 and 2023 Q1. Disproportionality analysis including the reporting odds ratio (ROR) was employed to quantify the signals of disproportionate reporting of pulmonary haemorrhage and haemoptysis adverse events (AEs) associated with BV-related treatment regimens. The demographic characteristics, time to onset and outcomes were further clarified. Results: A total of 55,184 BV-associated reports were extracted from the FAERS database, of which 497 reports related to pulmonary haemorrhage and haemoptysis. Overall, the median onset time of pulmonary haemorrhage and haemoptysis AEs was 43 days (interquartile range (IQR) 15-117 days). In the subgroup analysis, BV plus targeted therapy had the longest median onset time of 90.5 days (IQR 34-178.5 days), while BV plus chemotherapy had the shortest of 40.5 days (IQR 14-90.25). BV plus chemotherapy disproportionately reported the highest percentage of death (148 deaths out of 292 cases, 50.68%). Moreover, the BV-related treatments including four subgroups in our study demonstrated the positive signals with the association of disproportionate reporting of pulmonary haemorrhage and haemoptysis. Notably, BV plus chemotherapy showed a significant higher reporting risk in pulmonary haemorrhage and haemoptysis signals of disproportionate reporting in comparison to BV monotherapy (ROR 5.35 [95% CI, 4.78-6.02] vs. ROR 4.19 [95% CI, 3.56-4.91], p = 0.0147). Conclusion: This study characterized the reporting of pulmonary haemorrhage and haemoptysis, along with the time to onset and demographic characteristics among different BV-related treatment options. It could provide valuable evidence for further studies and clinical practice of BV.

Using clinician and patient input to assess utility, accuracy, efficiency, and therapeutic implementation of a new data-driven digital therapeutic for personalized clinical eating disorder treatment: Awaken digital guide

Objective Eating disorders (EDs) take a life every 52 minutes and treatments are ineffective for ∼50% of individuals. Though EDs are heterogeneous illnesses, current evidence-based treatments take a “one-size-fits-all” approach. Network-Informed Personalized Treatment is a new promising treatment for EDs, but clinician-patient-friendly software tools are needed to integrate this guidance system into routine treatment. Adoption is key for impact, necessitating the inclusion of clinicians in the software development. The current pilot assessed a new data-driven clinician-guidance therapeutic. Method A two-part pilot was analyzed for quantitative (0-not at all to 10-extremely) and qualitative input on user perception through quantitative and open-ended prompted questions evaluating using personalizing ED treatment with the Awaken Digital Guide therapeutic. Results Results demonstrated that clinicians in a focus group (N = 9) and clinician/patient dyads within implementation (N = 10) endorsed improved efficiency, effectiveness, self-awareness, and accuracy using Awaken Digital Guide compared to current treatment as suggested by quantitative and qualitative results. Both clinicians and patients rated the tool positively (6.8-9.6/5.8-8.6, respectively) with an average rating of good and excellent. Conclusion Findings suggest that ED-specialized clinicians desire data-driven guidance on personalizing ED treatment. Users perceive Awaken Digital Guide therapeutic with potential to increase collaboration, motivation, efficiency, and effectiveness of ED personalized treatment.

The Effects of Preoperative Video-Assisted Education on Anxiety and Comfort After Breast Cancer Surgery: Nonrandomized Controlled Study

PurposeThis study aimed to determine the effects of video-assisted education given before breast cancer surgery on patients' anxiety and comfort. DesignA non-randomized, controlled, quasi-experimental model was designed. MethodsThe study was conducted in the general surgery clinic of a public hospital. Seventy patients voluntarily participated in the study, 35 of them were in the Control (CG) and 35 of them were in the Experimental Group (EG). While routine treatment and care were given to CG, besides this a video-assisted education was provided to EG. The data was collected using the Personal Information Form, State-Trait Anxiety Inventory (STAI), and General Comfort Questionnaire (GCQ). The patients in both groups filled in the STAI and GCQ on the first day preoperatively, STAI-S and GCS on the second postoperative day and STAI-S on the tenth day after surgery. P<0.05 was accepted as a statistical significance value. FindingsThe groups were similar in terms of descriptive features and preoperative anxiety scores (p>0.05). Postoperative second and tenth day anxiety scores were significantly higher in CG (43.97±9.42 and 39.45±3.88) compared to EG (33.29±4.94 and 33.31±3.01) (p<0.05). In terms of the mean scores of the GCQ and its subscales of comfort, preoperative comfort was found to be lower than postoperative comfort level (p<0.05). ConclusionIt was determined that the preoperative video-assisted education decreased the anxiety level and increased the comfort level in EG. It was concluded that the use of video-assisted education in reducing anxiety and increasing the perception of comfort in breast cancer surgery patients would be beneficial.

Role of antioxidants in reducing oxidative stress and seizure frequency in drug-resistant epileptic patients.

Drug-resistant epilepsy presents significant challenges in treating epileptic patients, leading to recurrent seizures and necessitating the use of polypharmacy with anti-epileptic drugs. Both of these conditions contribute to increased oxidative stress, which is detrimental to the brain. The aim of this study was to determine the role of vitamins C and E in reducing oxidative stress and seizure frequency in drug-resistant epileptic patients. This was a double-blinded, randomized clinical trial with a placebo, parallel design, and block randomization. The subjects were drug-resistant epileptic patients aged 1-18 years who received routine treatment. Randomization was performed on 100 patients who were divided into the treatment or placebo groups. The patients received a combination of vitamin C (100 mg/day) and vitamin E (200 IU/day for those <5 years or 400 IU/day for those ≥5 years) or a placebo for eight weeks. Malondialdehyde (MDA) levels and seizure frequency were measured prior to and after the intervention. A total of 42 and 46 patients were followed till the end of the study in the intervention and placebo groups, respectively. Our data indicated that the MDA levels prior to treatment were not significantly different between the treatment and placebo groups (0.901 vs 0.890 mmol/mL, p=0.920) and were significantly reduced after the treatment in both the treatment group (p<0.001) and placebo group (p=0.028). The changes in MDA levels (between post- and pre-treatment) were also not significantly different between the two groups (p=0.181). Our per-protocol analysis indicated that the reduction in seizure frequency was significantly higher in the treatment group compared to the placebo group (95% vs 35%, p<0.001), with 92% and 60% relative and absolute risk reduction, respectively. The intention-to-treat analysis also indicated that the reduction in seizure frequency was significantly higher in the intervention group than in the control group (80% vs 32%, p<0.001), with relative and absolute risk reduction of 70% and 48%, respectively. There was no significant relationship between changes in MDA levels and seizure frequency in either group. In conclusion, vitamins C and E could reduce seizure frequency and, therefore, could be considered as adjuvant therapy in drug-resistant epileptic patients.

Effects of chronic neck pain on grip strength and psychomotor skills in adults.

It can be challenging to perform activities of daily living in patients with chronic neck pain. As the severity of the pain increases, the quality of the movements decreases. Not only the neck, but also the shoulder, elbow, grip strength and psychomotor skills are affected by these pains. In this study, it was aimed to investigate the effect of neck pain on grip strength and psychomotor skills in adults diagnosed with chronic neck pain. A cross-sectional study was conducted to examine the effect of pain on grip strength and psychomotor skills in patients with chronic neck pain. This study was planned to be carried out between October 2019 and May 2020 at the Private Yaşam Medical Center in Adana, with the official permission of the institution manager, but this period was carried out between October 2019 and November 2020 due to the fact that sufficient number of patients could not be reached due to the COVID-19 global epidemic. A total of 80 individuals, including 40 control and 40 patients, were included in the study. Forty adult patients who applied to the clinic with a diagnosis of chronic neck pain and 40 healthy adults without a diagnosis of chronic neck pain were included in the study. Conducted with 80 adults between the age of 19 and 74 years old. Individuals were divided into Group 1-control group (n = 40) and Group 2-patient group (n = 40). Information such as age, height, body weight and occupation of the groups were noted. Visual analogue scale and Neck Disability Index were applied to both the groups; hand grip strength with a Jamar hydraulic hand dynamometer, finger lateral grip strength with a pinchmeter and psychomotor skills with the Purdue Pegboard test were evaluated. In the study, hand grip strength (p < .05), finger lateral grip strength (p < .05), psychomotor skills (p < .01) showed a statistically significant decrease in the patient group compared to the control group. It is thought that in addition to the routine treatments for neck pain in the treatment plan of patients with chronic neck pain, exercises to improve the functionality and psychomotor skills in daily living activities can be included in the direction of increasing the grip strength and will guide future studies.