Safe Research Articles

Stem Cells: A Reformist Therapeutic Approach to Orthopaedic Sports Medicine

Background: The aim of the research is to identify, study the effects of stem cell therapies on sports injuries and examine how stem cell therapies may benefit the healing process and improve the athletes' physical state. With an extensive literature review, the purpose of this article to investigate the true potentials of regenerative stem cell therapy and shed light on innovative ways of treatment for sports injuries. It is theorized that stem cell therapy is an efficient and effective treatment method for sports injuries. Stem cell therapy is an innovative way of treating musculoskeletal injuries to provide faster and safer treatment to athletes. As sports injuries are one of the major concerns of the athletes, stem cell therapies are quite promising with effective and safe results. It is possible to fully heal certain injuries, regain functions, and reduce symptoms. Stem cell therapy is a method that should be popularised and preferred particularly by athletes.

Comportamento sexual e ocorrência de sífilis em estudantes universitários da área da saúde

OBJETIVO: Analisar o comportamento sexual e a ocorrência de sífilis em estudantes da área da saúde de uma universidade pública do estado do Piauí. MÉTODO: Estudo epidemiológico, transversal, realizado no período de outubro de 2017 a fevereiro de 2018, com 357 estudantes universitários da área da saúde. Os dados foram coletados por meio de questionário, com perguntas fechadas e semiabertas, e teste rápido para Sífilis. Foram realizadas análises univariadas e bivariadas por meio da distribuição de frequências e teste exato de Fisher. Os dados foram analisados com o uso do Statistical Package for the Social Sciences. RESULTADOS: Verificou-se que 135 (37,8%) estudantes afirmaram não utilizar o preservativo em todas as relações sexuais; 200 (56,0%) foram classificados com comportamento sexual de risco; a frequência do uso de bebida alcoólica apresentou associação significativa com comportamento sexual de risco (p=0,001). Foram detectados 2 (0,6%) resultados reagentes para sífilis, ambos discentes do curso de Odontologia. CONCLUSÃO: Embora a ocorrência de sífilis nos estudantes tenha sido abaixo da esperada, a utilização de álcool previamente às relações sexuais pode comprometer práticas sexuais seguras.

Convalescent Plasma Therapy in Patients with Severe COVID-19

Immunotherapy with neutralizing antibodies present in convalescent plasma (CP) proved to be effective and safe for patients with SARS (severe acute

Progress in development of neutralizing monoclonal antibody (McAb) against MERS-CoV

The rapid spread and outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the regions of Middle East in 2012 have been a great concern for researchers worldwide. Thus, efficient preventative and therapeutic countermeasures are urgently needed. Clinical studies have confirmed that high titers of neutralizing antibodies (Abs) against MERS-CoV in patients during convalescence have protective potency, which indicates that neutralizing Abs are safe and effective for the treatment of MERS-CoV infection. Spike (S) protein is a key structural protein that mediates MERS-CoV infection and currently a critical protein for studying MERS-CoV neutralizing monoclonal antibodies. This review summarizes recent advances in identifying neutralizing McAbs against MERS-CoV through describing the structural characteristics of MERS-CoV S protein, different kinds of MERS-CoV vaccines and methods for mAbs screening. Furthermore, we propose the prospects for future research on MERS-CoV neutralizing McAbs according to the current research progress. Key words: MERS-CoV; McAb; Neutralization; Spike protein; RBD

Comparison of the performance of two methods to determine set-up errors for DIBH patients with left sided breast cancer in radiotherapy

Objective To establish the basic procedures of the application of optical surface monitoring system (OSMS) in the deep inspiration breath hold (DIBH) radiotherapy for patients with left sided breast cancer and compare the performance of OSMS and cone-beam CT (CBCT) in the determination of the set-up errors of DIBH radiotherapy for patients with left sided breast cancer. Methods Twenty patients with left sided breast cancer received DIBH radiotherapy. Through the registration of CBCT images with the planning CT images, and the registration of OSMS radiography images with the outer contour of the body surface, translational set-up errors and rotational errors were determined along the lateral-medial (Rx), superior-inferior (Ry) and anterior-posterior (Rz) directions. Pearson correlation analysis was performed to evaluate the correlation of the set-up errors determined by two methods, and Bland-Altman plot analysis was used to assess the coincidence of these two methods. Results Two methods were positively correlated. The Rz volume was 0.84, 0.74 and 0.84 in the x, y and z directions, and 0.65, 0.41 and 0.54 in the Rx, Ry and Rz directions, respectively (all P<0.01). The 95%CI of agreement were within preset 5 mm tolerance (-0.37-0.42cm, -0.39-0.41cm, -0.29-0.49cm ) in x, y and z directions for two methods. The 95%CI of agreement were within preset 3 ° tolerance -2.9°-1.4°, -2.6°-1.4°, -2.4°-2.5°in Rx, Ry and Rz directions for two methods. The system errors of 20 patients with left sided breast cancer receiving DIBH radiotherapy were <0.18cm and the random errors were <0.24cm. Conclusions OSMS is equivalent to CBCT in the determination and stimulation of set-up errors for patients with left sided breast cancer receiving DIBH radiotherapy. The combination of CBCT and OSMS is a safe and reliable method. Key words: Optical surface monitoring system; Deep inspiration breath hold; Image registration

Clinical Trial of Liraglutide for Obesity in Adolescence

Lifestyle modification is first-line therapy among youth with obesity but generally has poor results. In the search to identify safe and effective

ERODIBILIDADE DE SOLOS DERIVADOS DE ROCHAS DA SUÍTE SERRA DOS ÓRGÃOS: IMPLICAÇÕES PARA A INSTABILIDADE DE TALUDES DE CORTE

Problemas de instabilidade de taludes podem ser deflagrados por processos erosivos nos horizontes de solos saprolítcos. Nesses casos, a identificação das causas e a análise dos processos instabilizadores pode não ser uma tarefa trivial. Embora a associação dos processos de deslizamento e erosão seja relativamente comum, nem sempre as relações entre causa e efeito são bem definidas, podendo impactar significativamente os custos dos projetos e obras de instablização. Portanto, ainda é necessário avançar na identificação prévia das erodibilidades dos solos saprolíticos, os quais em condições críticas podem deflagrar a instabilidade dos horizontes superiores do solo. O principal objetivo desse manuscrito é avaliar índices que auxiliem na previsão da erodibilidade de solos saprolíticos e seu potencial na deflagração de processos de movimentos de massa em encostas ou taludes instáveis. Foram selecionados para análises dois perfis de solo, incluindo o solo saprolítico e os horizontes pedológicos, derivados de rochas da Suíte Serra dos órgãos e com registro de instabilidades e evidencias de feições erosivas observadas em campo, no município de São João de Meriti (RJ). Após a amostragem, os horizontes pedológicos e saprolíticos de cada perfil foram analisados quanto à mineralogia, propriedades físicas e mecânicas. Os resultados obtidos em laboratório confirmam as observações de campo quanto à elevada erodibilidade do solo saprolítico e seu potencial para deflagração de rupturas dos taludes de corte na região. Esse conhecimento fundamental é útil para assistir às autoridades municipais quanto ao uso do solo urbano, em especial, para a necessidade de se evitar cortes profundos e assim manter a preservação dos horizontes saprolíticos e o equilíbrio das encostas.

Violência sexual na adolescência: contribuições da Psicologia

O presente artigo se dá como uma revisão bibliográfica, sistemática, qualitativa e descritiva, que utilizou como critério de seleção literaturas dos últimos 35 anos sobre os contextos e os impactos da violência sexual na adolescência, a partir do objetivo de investigar quais as contribuições da psicologia aos adolescentes vítimas de violência sexual, na medida em que estimula a exploração quanto aos seus conceitos, seus contextos e suas consequências psicológicas, por considerar a Psicologia como uma forte rede de apoio, capaz de ser uma importante ferramenta na construção de um ambiente seguro e acolhedor, como também de promoção a livre expressão da vítima quanto seus sofrimentos e sentimentos ocasionados pela violência e de seus tratamentos, sugerindo, por fim, uma aliança do fazer psicológico com certa intervenção por parte do poder público, a partir da construção de políticas e práticas tanto para prevenir e conscientizar, quanto para tratar os problemas de saúde e de segurança direcionados a sujeitos em situação de violências sexuais de alta vulnerabilidade, como os adolescentes em questão.

Clinical analysis of 69 cases of non-HIV-related cryptococcal meningitis

The clinical data of 69 patients with non-HIV-related cryptococcal meningitis admitted in the Second Hospital of Hebei Medical University from January 2013 to May 2019 were analyzed retrospectively.The main presentations of 69 patients are headache,fever,nausea,vomiting, visual impairment, hearing damage.Among them, 36 cases (52%) had underlying diseases, 30 cases (43%) were misdiagnosed, and 38 cases (55%) were complicated with high intracranial pressure. Cerebrospinal fluid examination showed that leukocytes increased in 47 cases, protein increased in 55 cases, chloride decreased in 41 cases, glucose decreased in 34 cases. The imaging findings were cerebral ischemia, hydrocephalus, meningeal or cerebral parenchyma enhancement. During the induction period, 63 cases were treated with combined antifungal drugs and 6 cases were treated with single antifungal drugs. The clinical symptoms were improved in 54 cases, 9 cases were discharged automatically and 6 cases died. The clinical manifestations, routine and biochemical examination of cerebrospinal fluid, imaging findings are not specific for patients with non-HIV-related cryptococcal meningitis.So early and multiple lumbar puncture should be performed to find etiological evidence to reduce misdiagnosis. The combination of antifungal drugs during the induction period is safe and effective. Key words: Meningitis,cryptococcal; Antifungal agents; Intracranial pressure; Neurosurgical procedures

Comparative study between Surgical and Endovascular Management of Chronic Iliofemoral Venous Obstruction

Background: Most of the chronic iliofemoral venous obstructions were managed with low morbidity and no mortality through endovascular intervention which was appropriate for patients with chronic venous obstruction. Endovascular treatment for iliofemoral venous obstruction had progressed rapidly,venous stenting was the primary choice as the stent placement was safe, effective and minimally invasive. However, surgical treatment remains an excellent option in cases in which endovascular techniques had failed or weren’t possible. Objective: The purpose of this study was to review and discuss comparative study between surgical and endovascular procedures in the management of chronic iliofemoral venous obstruction. Patients and Methods: This study included 30 patients (18 females and 12 males) with a ratio of 1.5:1 suffering from chronic ilio-femoral venous obstruction, randomly divided into two equal groups: group (1) for surgical treatment,group (2) for endovascular treatment. Their mean age was 40 years “ranging from 19-83 years” . All patients were belonging to CEAP classifications, C(clinical), E(etiological), A(anatomical) and P(pathological) which included C3 to C6 = clinically state of venous disease in which there was edema up to active venous ulcer. Results: There was no difference between the groups regarding the length of follow up. Iliofemoral venous stenting was safe and effective procedure which could be performed with low morbidity, no mortality, and long-term high patency rate patients for open venous surgery had complication with low patency rate. Conclusion: Endovascular treatmentis the primary treatment for patients with chronic iliofemoral venous obstruction, open surgical treatment should be considered only in cases of unsuccessful or failed endovenous treatment.

Effects of metformin alone and in combination with spironolactone on hyperandrogenism in polycystic ovarian syndrome

Objective To evaluate the efficacy of combined therapy with metformin and low-dose spironolactone as compared with metformin alone on the clinical and endocrine-metabolic alterations of patients with polycystic ovarian syndrome (PCOS). Background PCOS is the most common endocrinological disorder in reproductive-age women. Thus, at least theoretically, metformin plus spironolactone therapy may be an effective and safe combination for PCOS. Patients and methods A prospective randomized comparative study was carried out on 48 patients with the PCOS in Obstetrics and Gynecology Department, Menoufia University Hospital, and Al-Shohadaa Hospital, Egypt, from the period of May 2016 till January 2018. Detailed history, laboratory investigations, obstetric examination, and follow-up were done. Results Mean hirsutism score and BMI (kg/m2) were 10.8 ± 3.9 and 26.8 ± 2.2, respectively, before treatment, which decreased significantly to 7.6 ± 2.4 and 22.10 ± 1.92, respectively, after 6 months of treatment. Luteinizing hormone, follicle-stimulating hormone, free testosterone, dehydroepiandrosterone sulfate, fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance were decreased significantly after 6 months of treatment as compared with before treatment among women who received metformin + hypocaloric diet and received metformin + spironolactone + hypocaloric diet before treatment. Free testosterone was decreased in group B (58.2 ± 9.1) more than group A (73.6 ± 12. 9). Conclusion The results confirm the beneficial effects of metformin in patients with PCOS. It also proves that the addition of low-dose spironolactone induces a more marked reduction of clinical and biochemical hyperandrogenism in patients with PCOS present with hyperandrogenic conditions.

Innovative Mixed Microbial Culture Processes for Pha Production at Pilot Scale: Professional Chemical Risk Assessment

Identification and fine-tuning of a process that allows the effective conversion of organic carbon from urban waste into valuable bio-based products is the main goal of “REsources from URban BIowaSte”- RES URBIS (GA 7303499) project in the European Horizon2020 program.In this frame, the Mixed Microbial Culture (MMC) process for polyhydroxyalkanoates (PHA) production has not been exploited at full scale yet and the process is presently under investigation only at pilot scale.The successful development and the industrial implementation of a safe biochemical conversion process is essential for meeting sustainable development goals. Although the health and safety risks posed by bioprocesses for the valorisation of biomass are usually expected to be lower than the traditional chemical and petrochemical processes, there is still a lack of information about these aspects of biorefinery plants, especially for novel bioprocesses under development.Taking steps to meet this challenge, the work presents early results of professional chemical risk assessment in application to the MMC-PHA production process at pilot plant scale. The assessment has been performed applying a guideline drawn up by Italian National System for Environmental Protection for the protection of operators from risks to their safety and health arising, or likely to arise, from the effects of chemical agents that are present at the workplace or as a result of any work activity involving chemical agents. Meeting the requirements of Community legislation and the updates introduced by EC Regulation 1907/2006 (REACH, 2006) and EC Regulation 1272/2008 (CLP, 2008), the guideline provides a methodology for chemical risk assessment distinguishing between risks for safety, related to reactivity and chemical-physical properties of chemicals, and risks for health, mainly ascribable to toxicological properties of chemical agents.Starting from the analysis of the Process Flow Diagram of a pilot scale plant for PHA production, a lot of information (hazardous properties of chemical agents, circumstances of work involving such agents, including their amount, level, type and duration of exposure, relevant material safety data sheets, occupational exposure limit values, effect of preventive measures taken or to be taken) has been collected in order to apply the guideline criteria and the joined IT tool. The paper presents the results of the assessment attempt.

Safety and efficacy of propofol alone or in combination with other agents for sedation of patients undergoing colonoscopy: an updated meta-analysis.

The aim of this meta-analysis was to assess the efficacy and safety of propofol sedation for colonoscopy in comparison with traditional sedative agents. We performed a systematic search of PubMed, Embase, Scopus, Web of Science CENTRAL (Cochrane Central Register of Controlled Trials) and Google Scholar databases to identify eligible randomized controlled trials (RCTs) published before November 2019, and compared the effect of traditional sedative agents (TA) with the effect of propofol/propofol combined with TAs for routine colonoscopy. We included 22 eligible trials in our analysis, with a total of 2575 participants. We found strong associations between propofol use and short recovery (SMD MD, -1.15 [-1.55, -0.75], p<0.00001), procedure duration (SMD -0.28 [-0.55, -0.02], p<0.05), discharge times (SMD= -0.71 [-1.06, -0.36], p<0.0001), and sedation scores (SMD 1.29 [0.36, 2.22], p<0.05). Propofol in combination with traditional agents led to a significant decrease in discharge time compared with the discharge times of traditional sedatives alone (SMD=-0.69 [-1.07, -0.31], p<0.0004). The effects of propofol on cecal intubation rates, and occurrences of hypotension and apnea were similar to those of TAs. Our results suggest that propofol can be used as a safe alternative to TAs, and can significantly shorten procedure duration, recovery and discharge times, and improve sedation depth.

Is cervical ripening balloon used in conjunction with pharmacological cervical ripening both safe and more effective than either method used alone?

Is cervical ripening balloon used in conjunction with pharmacological cervical ripening both safe and more effective than either method used alone?

New Safe Brace campaign alerts patients to the dangers of 'DIY Braces'

New Safe Brace campaign alerts patients to the dangers of 'DIY Braces'

Nursing care of patients with cardiogenic shock combined with acute respiratory distress syndrome treated by extracorporeal membrane oxygenation and transferred outer-hospital in long distance

Objective To summarize the nursing experience in 2 patients with cardiogenic shock combined with acute respiratory distress syndrome(ARDS) treated by extracorporeal membrane oxygenation (ECMO) and transferred outer-hospital in long distance. Methods There were many risk factors in this transport: high parameters of ECMO included V-A mode, 100% oxygen, and a flow of oxygen from 6 L/min to 10 L/min. High ventilator parameters included oxygen concentration of 100% and positive end-expiratory pressure of 15-17 cmH2O(1 cmH2O=0.098 kPa). Transport distance was up to 196 km. And the transport time was up to 2 h 36 min. In this regard, we carried out adequate preparations before transport and professional cares during transport. The main points were as follows: setted up a professional transport team; prepared adequate power and oxygen supply; reduced the number of interruption of ECMO and ventilator support during transport; provided the reasonable remedial actions when ECMO and ventilator support were interrupted. Results Two patients arrived at the destination safely. Conclusions Adequate preparations before transport and professional cares during transport could effectively avoid and respond to the occurrence of adverse events, and it is feasible and safe to patients supported by ECMO for long distance outer-hospital transport. Key words: Extracorporeal membrane oxygenation; Cardiogenic shock; Acute respiratory distress syndrome; Patient transfer

Effect of methylene diphosphate combined with strontium chloride in the treatment of bone pain caused by multiple bone metastases

Objective To investigate the clinical efficacy of Yunke(99TC-MDP) combined with strontium 89SrCl2 in the treatment of bone pain in patients with multiple bone metastases. Methods The clinical data of 95 patients with multiple bone metastases admitted to the General Hospital of Datong Coal Group from August 2014 to July 2019 were retrospectively analyzed.According to the different treatment methods, they were divided into three groups: 37 patients in Yunke group were treated with Yunke alone, 29 patients in 89SrCl2 group were treated with 89SrCl2 alone, 29 patients in combination group were treated with Yunke combined with 89SrCl2.All patients were treated for 5 days, with a course of treatment per month.The clinical efficacy, analgesic time and adverse reactions of the three groups were compared. Results After treatment, the pain relief rates of the Yunke group, the 89SrCl2 group and the combination group were 67.6%(25/37), 69.0%(20/29) and 79.3%(23/29), respectively.The pain relief rate of the combined group was higher than that of the Yunke group(χ2=4.25, P<0.05). The effective rate of bone metastases in the combined group was 41.4%(12/29), which was higher than that in the Yunke group[0.0%(0/37)], the 89SrCl2 group[17.2%(5/29)], the differences were statistically significant(χ2=13.09, 10.54, all P<0.01). No serious adverse reactions were found in the three groups. Conclusion Yunke combined with 89SrCl2 is superior to 89SrCl2 alone, and it is safe in the treatment of bone metastases. Key words: Neoplasm metastasis; Metastatic carcinoma of bone; Bone pain; Methylene diphosphate; Strontium chloride; Comparative study

Valproic acid-induced normal pressure hydrocephalus in a tertiary care hospital

Behavioral and psychological symptoms of dementia (BPSD) are a common psychological disorder in the geriatric population with dementia. The causes and risk factors are multiple, and they include biological, psychological, and environmental variables. The combination of these symptoms, rather than any specific factor, explains the occurrence of BPSD in an individual patient. Treatment is targeted to a specific symptom; anticonvulsants such as valproic acid (VPA), carbamazepine, and anti-psychotics have been used to treat agitation in elderly patients. Atypical antipsychotics are used to treat psychosis, and Selective Serotonin Reuptake inhibitors are used to treat depression and anxiety. VPA is dosed using the weight-based dosing approach, which is usually found to be very safe and effective in elderly patients. However, in certain cases, it has also been known to produce reversible neurological symptoms such as dementia, altered sensorium, psychological disturbances, and normal pressure hydrocephalus (NPH) on its prolonged use. The present case report is unique as we identified that an elderly patient with a history hypertension, type 2 Diabetes and asthma, and BPSD was diagnosed with NPH after a short-term treatment with Divalproex sodium-125 mg which is once daily which was added on to his on-going therapy to better control his symptoms.

Erector spinae plane block for postoperative analgesia after total laparoscopic hysterectomy: case series and review of the literature.

Total laparoscopic hysterectomy (TLH) is associated with significant postoperative pain that worsens outcomes and prolongs hospital stay. Ultrasound guided erector spinae plane block (ESPB) is a new technique for thoracic analgesia. Few cases have been described for postoperative analgesia in laparoscopy. We describe the use of preoperatory bilateral ESPB at level T10 to provide postoperative analgesia following THL. We enrolled 10 ASA 1-2 patients scheduled for TLH. After written informed consent we performed bilateral ESPB at T10 level in sitting position, with a linear probe and in plane cranio-caudal approach and ropivacaine 0.5% 20 for each side. The sensitive block was tested by pinprick. Standard general anesthesia was administered. Patient controlled analgesia (PCA) with morphine 1 mg/ml was delivered. We measured postoperative pain by visual analogue scale (VAS). Five patients (50%) underwent simple TLH, 5 women (50%) had TLH plus salpingo-oophorectomy. VAS scores was <4 in all cases but one, and PCA morphine consumption was 4.1 ± 3.5 mg (mean ± SD). Pinprick was positive bilaterally in 3 patients (30%). ESPB was an effective and safe procedure for postoperative pain control after TLH. Future research should compare ESPB to other techniques to assess its role on perioperative management of THL.

What is the best diet to recommend when treating obesity? 2. The choice between high-carbohydrate, high-fat and high-protein options.

Objective. The objective of this three-part narrative review is to examine empirical data on the best type of diet to recommend to clients with established obesity that are being treated by an exercise-centred weight reduction programme. The present section of the review considers the relative merits of high-carbohydrate, high-fat, and high-protein options. Methods. Information obtained from Ovid/Medline, PubMed and Google Scholar through to August 2019 was supplemented by a search of the author's extensive personal files. Results. Any proposed diet must meet basic needs for protein, essential fatty acids and micronutrients, but once such demands have been satisfied there is a vigorous competition between proponents of high-carbohydrate, high-fat, and high-protein dietary emphases. Discussion has focused on the respective abilities of these choices to prolong satiety and encourage adherence to the recommended regimen, to conserve lean tissue, to stimulate thermogenesis and to encourage the metabolism of fat. However, to date randomized controlled experiments have shown relatively little difference in the long-term weight reductions achieved with the three options. The main determinant of successin weight loss seems not the choice of diet but rather faithful adherence to whichever regimen is chosen. Conclusions. The optimal approach to weight loss comprises a moderate but consistent reduction of daily energy intake and faithful adherence to a programme of moderate physical activity. There seems little difference in the long-term weight-loss achieved by following a high-carbohydrate, a high-fat or a high-protein diet. The challenge for health professionals is to develop safe methods of reaching an effective dose of exercise, and to sustain the enthusiasm of programme participants for both dieting and increased physical activity until weight-reduction goals have been met.