T2 In Group Research Articles

The impact of early surgical ventricular septal defect repair on parenting behavior and mother-child relationship: a prospective longitudinal study

IntroductionMany studies have investigated the impact of congenital heart defects (CHD) on child development. However, because CHD not only affects the child and his or her development but, also the entire family, family functioning after pediatric cardiac surgery is of increasing research interest. This prospective childhood-adolescence case-control study aimed to examine differences and changes in parenting behavior and mother-child relationship quality after early surgical repair of an isolated ventricular septum defect (VSD) compared to non-affected controls.Patients and methods39 affected children (M = 7.3 years) with surgically repaired VSD and their mothers were compared with a matched, non-affected control group of 39 mother-child-dyads (M = 7.3 years) during primary school age (t1). At child early adolescence, 24 affected children (M = 12.4 years) and 24 children of the control group (M = 13.2 years) were examined again (t2). Parenting behavior characteristics (t1: mother report; t2: mother- and child report) and mother-child relationship quality (t2: child report) were measured by standardized questionnaires.ResultsThe mother-rated parenting behavior dimensions Involvement (p < .001, η2p = .37), Parental Monitoring (p = .014, η2p = .17) and Corporal Punishment (p < .001, η2p = .57) significantly decreased from t1 to t2 in both cohorts. Responsible Parenting Behavior tended to decrease from t1 to t2 in the control group, while remaining stable in the VSD-group (p = .088, η2p = .09). Independent of the group, higher mother-child relationship quality was associated with more Positive Parenting Behavior (p < .001, η2p = .34), more Involvement (p = .003, η2p = .22) and fewer Inconsistency (p < .001, η2p = .31) in the child-rating; and more Positive Parenting Behavior in the mother-rating (p = .039, η2p = .10).ConclusionVSD affected mother-child-dyads were mostly comparable in their parenting behavior characteristics and mother-child relationship quality to non-affected controls. The absence of a decrease in maternal Responsible Parenting Behavior in the VSD group may indicate challenges during the developmental task of autonomy in adolescence. Nevertheless, adaptive family functioning after early pediatric surgical VSD repair seems possible.

6669 Association Between Serum Levels of Thyroid Function and Per- and Polyfluoroalkyl Compounds Concentrations in Central Precocious Puberty in Girls

Abstract Disclosure: Y. Li: None. Y. Xing: None. X. Yin: None. J. Yang: None. S. Zang: None. T. Dong: None. Y. Pan: None. J. Dai: None. P. Li: None. Background: Exposure to per- and polyfluoroalkyl substances (PFASs) may interfere with thyroid function in the general population and disturb the timing of puberty onset. Objectives: We investigated the possible relationship between PFASs and thyroid hormone (THs) exposure in girls with central precocious puberty (CPP). Methods: In a prospective study initially established for assessing CPP, 627 serum samples were collected with (n = 226) and without (n = 401) CPP. The concentrations of 25 PFASs, thyroxin (T4), 3,5,3’-triiodothyronine (T3), and 3,3’,5’-triiodothyronine (rT3) were measured. We used logistic regression to examine the association of THs with the odds of having CPP and multiple linear regression to analyze the associations between THs and various PFASs in the CPP and control groups. Results: The levels of T4 in the CPP group were significantly lower than those in the control group, and the levels of T3 and rT3 were significantly higher than those in the control group. After adjusting for confounders, T3 concentrations were associated with 1.526-fold increased odds of having CPP [odds ratio (OR) = 1.526, 95% confidence interval (CI):1.216-1.914]. In the CPP cohort, perfluoroheptanoic acid (PFHpA), perfluoro (2-ethoxyethane) sulphonic acid (PFEESA), and fluorotelomer phosphate diester (6:2/8:2 diPAP) were inversely associated with T3; perfluorobutanoic acid (PFBA) was inversely associated with T4, and PFEESA and 6:2/8:2 diPAP positively associated with T4; PFBA was positively associated with rT3, and perfluorooctane sulfonic acid (PFOS) was inversely associated with rT. In the control cohort, perfluorobutanesulfonic acid (PFBS) was positively associated with T3, and PFEESA and 6:2/8:2 diPAP were inversely associated with T3, and these PFASs had an adverse association with T4. Perfluorohexanoic acid (PFHxA) was positively associated with rT3, and 6:2/8:2 diPAP was negatively associated with rT3. Conclusion: In this study, different measurements of PFASs and THs were observed in the CPP and control groups. Discrepancies in exposure to PFASs were associated with THs in the CPP cohort and healthy girls. Further research is necessary to investigate the mechanism by which PFASs affect the timing of puberty onset and thyroid function. Presentation: 6/1/2024

Cerebellar tDCS combined with augmented reality treadmill for freezing of gait in Parkinson's disease: a randomized controlled trial.

Parkinson's disease (PD) is often accompanied by gait disorders and freezing of gait (FoG), disabling symptoms that are resistant to conventional dopamine treatments. Given the cerebellum's connectivity with the motor cortex and basal ganglia, and its implication in PD, combining transcranial direct current stimulation targeting the cerebellum (ctDCS) with physical exercise might improve gait and balance. This study aimed to evaluate the effectiveness of a novel rehabilitation approach that combines noninvasive cerebellar stimulation with motor-cognitive training via an augmented reality treadmill (C-Mill VR+) in individuals with PD and FoG. Seventeen individuals with PD exhibiting FoG were enrolled in a randomized controlled trial. The participants were randomly assigned to a group receiving motor-cognitive training on the C-Mill VR+ with either ctDCS or sham ctDCS. Assessments were conducted pre-intervention (T0), post-intervention (T1) after 10 sessions, and at 4-week follow-up (T2), using various clinical scales. Additionally, C-Mill assessments of postural stability and gait were conducted at T0 and T1. Although no significant time*group interactions were observed for any of the clinical variables measured, some were found in the C-Mill measures. Specifically, right lower limb sway in static conditions, both with eyes open (OAD) and eyes closed (OCD), significantly improved at T1 in the ctDCS group compared with the sham group. C-Mill outcomes indicate that the combined treatment may enhance motor control. Participants who received ctDCS along with augmented reality motor-cognitive training showed better postural stability.

Therapeutic Potential of the Algerian Ground Nut (Bunium bulbocastanum) Dietary Supplement in the Treatment of Thyroid-induced Dysfunction and Associated Growth Performance and Meat Quality in Rabbits (Oryctolagus cuniculus)

Background: Both traditional usage and initial scientific findings suggest that Bunium bulbocastanum, commonly known as Talghouda tuber nut, may offer health benefits, particularly for thyroid dysfunction. This study aims to investigate the therapeutic potential of dietary supplementation in managing pharmacologically thyroid-induced dysfunction and its effects on growth performance and meat quality in rabbits. Methods: Thirty 45-day-old male Lionhead rabbits were divided into three groups, each with two subgroups. The Control groups received either a standard diet (C) or a diet supplemented with 35% dried Talghouda (Csup). The Hypothyroid group included rabbits induced with hypothyroidism using carbimazole at a dose of 5 mg/kg BW/day (HytCar) and those subsequently treated with dried Talghouda (HytTal). Similarly, hyperthyroid group comprised rabbits induced with hyperthyroidism using levothyroxine (HyrLevo) and those treated with dried Talghouda (HyrTal). Thyroid function was assessed by measuring serum levels of T3, T4 and TSH. Additionally, growth performance and meat quality parameters were evaluated. Result: Talghouda supplementation significantly influenced thyroid hormone levels in rabbits, elevating T3 and T4 in the hyperthyroid groups (HyrLevo and HyrTal) compared to controls, while suppressing TSH in hyperthyroid groups and elevating it in hypothyroid groups. Talghouda treatment improved growth performance, evidenced by increased weight gain and higher eviscerated carcass weights in the hyperthyroid-treated groups. Meat quality also improved, with favourable pH, dry matter percentage and mineral content observed in the Talghouda-treated hypothyroid group. These findings suggest that Bunium bulbocastanum is a viable natural intervention for managing thyroid dysfunction while maintaining or enhancing growth and meat quality in rabbits, offering promising pharmacological and economic benefits.

Low T3 vs low T3T4 euthyroid sick syndrome in septic shock patients: A prospective observational cohort study.

Both phases of euthyroid sick syndrome (ESS) are associated with worse prognosis in septic shock patients. Although there are still no indications for supplementation therapy, there is no evidence that both phases (initial and prolonged) are adaptive or that only prolonged is maladaptive and requires supplementation. To analyze clinical, hemodynamic and laboratory differences in two groups of septic shock patients with ESS. A total of 47 septic shock patients with ESS were divided according to values of their thyroid hormones into low T3 and low T3T4 groups. The analysis included demographic data, mortality scores, intensive care unit stay, mechanical ventilation length and 28-day survival and laboratory with hemodynamics. The Simplified Acute Physiology Score II score (P = 0.029), dobutamine (P = 0.003) and epinephrine requirement (P = 0.000) and the incidence of renal failure and multiple organ failure (MOF) (P = 0.000) were significantly higher for the low T3T4. Hypoalbuminemia (P = 0.047), neutrophilia (P = 0.038), lymphopenia (P = 0.013) and lactatemia (P = 0.013) were more pronounced on T2 for the low T3T4 group compared to the low T3 group. Diastolic blood pressure at T0 (P = 0.017) and T1 (P = 0.007), as well as mean arterial pressure at T0 (P = 0.037) and T2 (P = 0.033) was higher for the low T3 group. The low T3T4 population is associated with higher frequency of renal insufficiency and MOF, with worse laboratory and hemodynamic parameters. These findings suggest potentially maladaptive changes in the chronic phase of septic shock.

Comparison between twin block appliance and mandibular advancement on clear aligners in the improvement of airway dimension: incremental versus maximum bite advancement.

The aim of the present retrospective study was to compare the changes resulting from treatment using the MA and the TB with special regard to the oro-and naso-pharyngeal sagittal airway dimensions in subjects with dentoskeletal Class II malocclusions and positive history of Sleep Disorder Breathing (SDB) diagnosed through the Pediatric Sleep Questionnaire (PSQ). This retrospective study involved 2 groups of subjects: patients treated with Twin Block (TB group: n = 22, 10 males, 12 females; mean age 12.0 ± 1.3 years) and patients treated with Mandibular Advancement (MA group: n = 23, 11 males, 12 females; mean age 12.2 ± 1.1 years). Pretreatment (T1) and posttreatment (T2) lateral cephalograms were analyzed. All patients underwent the PSQ to diagnose SDB. In both treated groups there was an increase in the airways dimensions and an improvement in symptoms related SDB. The statistical comparison of the changes between T1 and T2 in the TB group showed a significant increment in upper airway size (PNS-AD2, +1.50 mm + -3.30; McNamara's upper pharynx dimension, +2.21 + -4.21) after active treatment. The MA group showed similar results during active treatment with a significant increase in both upper (PNS-AD2, +2.72 + -2.65; McNamara's upper pharynx dimension, +2.97 + -3.07) and lower (PNS-AD1, +2.17 mm + -3.54) airway size. Despite the different structure of these two devices and the different advancement protocols, both appliances were valuable as a suitable treatment option for Class II patients with respiratory disorders, inducing an increase of upper and lower airway size and a significant reduction in diurnal symptoms.

Energy metabolism, immune function, and intestinal flora in rats with kidney-yin deficiency treated with raw or saltwater-processed Phellodendron chinense Schneid

ObjectiveTo clarify the specific mechanisms of action of raw Phellodendron chinense Schneid. (RPC) and saltwater-processed PC (SPC) in the treatment of rats with a kidney-yin deficiency pattern (KYDP). MethodsHealthy rats were administered hydrocortisone to establish a KYDP model. The rats were divided into seven groups: blank control, model, positive control (Liuwei Dihuang pills), high-dose RPC, low-dose RPC, high-dose SPC, and low-dose SPC. Enzyme-linked immunosorbent assay was used to measure the levels of cAMP, cGMP, TRH, TSH, T3, T4, IFN-γ, TNF-α, and testosterone in the serum and the levels of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in the liver. TRH mRNA expression in the rat hypothalamus was measured using RT-PCR. THRα1+2 protein expression in the hypothalamus of rats was measured using Western blot. Immunohistochemistry was performed to determine the expression levels of FAS, FasL, and TSHR. Flow cytometry was used to determine CD4+ and CD8+ T lymphocyte levels. Illumina MiSeq sequencing technology was used to evaluate the diversity of intestinal flora in KYDP rats. ResultsThe cAMP/cGMP ratio was significantly higher in the model group than in the blank control group (P = .048). Compared with the model group, after administration, the levels of the above-mentioned serum and liver indexes decreased, except that of testosterone. The CD4+/CD8+ ratio also decreased. Compared with the RPC group, the levels of T3, IFN-γ, FAS, FasL, and TSHR in the SPC group decreased whereas that of testosterone increased. Additionally, immune function and intestinal flora diversity improved in the SPC group. SPC proved to be more effective in improving liver energy metabolism in KYDP rats than RPC. ConclusionSPC had a better therapeutic effect on KYDP than RPC. The underlying mechanism of action may be related to improvements in liver energy metabolism, immune function, and intestinal flora diversity.

Effect of stocking density and feeding regimes on physiological recovery in stunted Labeo rohita fingerlings reared in cages

Aim: To find out the physiological recovery status of stunted fingerling of Labeo rohita reared in floating net cages at different stocking densities and feeding rations in cages. Methodology: Stunted fingerling (8 months) of L. rohita with an average body weight of 38.23 ± 1.90 g and length 14.65 ± 0.30 cm were stocked in cages at different densities viz. T1 (10), T2 (15), T3 (20) and T4 (25) fish m-3 and varying levels of feeding rations such as 3, 4, 5 and 6% for 330 days with crude protein (28%) pellet were fed twice a day. The 4×4 factorial design was used, and each stocking density and feeding level were triplicated. A total of 48 numbers of square shaped floating net cage, made of HDPE, each measuring 27 m-3 with 6 mm mesh size were used for the experiment. Results: A significant physiological recovery was observed in the T1 (10*5 and 10*6) treatment groups, which showed highest Hb (11.23± 0.08 g d l-1), RBC (2.83 ± 0.03 ×106 cum m-1), PCV (45.76 ± 0.16 %) and lymphocyte (69.32 ± 0.12 %) content at the end of the experiment. Similarly, significant changes were observed in glucose, cortisol, and lactate dehydrogenase, which were highest in T4 and normal in T1 group as the experiment progressed. Interpretation: The result of present study recommends that cage culture of stunted Labeo rohita is possible in Indian reservoirs with lower stocking density 10 m-2 and feeding ration of 5% body weight which maintains better physiological conditions for optimal growth of fish. Key words: Cage culture, Feeding ration, Labeo rohita, Physiological parameters, Stunted, Stocking density

Real-Time Monitoring of Lower Limb Oxygen Saturation in Children with Indwelling Catheters Using Near-Infrared Spectroscopy to Assess the Risk of Deep Vein Thrombosis and Nursing Strategies

Objectives: To analyze the risk of deep vein thrombosis (DVT) in children with indwelling catheters through near-infrared spectroscopy (NIRS) detection of lower limb crSaO2, and to implement corresponding nursing countermeasures against the risk. Methods: Using a convenience sampling method, 80 children with indwelling catheters were selected from the first pediatric intensive care unit of our hospital between January 2022 and December 2022. They were divided into two groups: The DVT group (N = 20) and the non-DVT group (N = 60), based on whether DVT occurred within 3 days of catheterization. Single-factor and multivariate logistic regression analyses were conducted using SPSS 27.0 software. Non-DVT patients were randomly divided into a study group and a control group using a random number table method, with 30 cases in each group. The control group received routine nursing measures, while the study group received nursing measures based on NIRS for detecting DVT risk in lower limb crSaO2 in children with indwelling catheters. The blood coagulation indexes [thrombin time (TT); activated partial thromboplastin time (APTT); fibrinogen (FIB); D-dimer (D-D)] of the two groups were compared at 3 days (T0), 7 days (T1), and 14 days (T2) after catheterization. The symptoms related to lower limb DVT during the study period were also recorded. Results: Multivariate logistic analysis showed that the independent risk factors for DVT in critically ill children with deep vein catheterization were bed rest time ≥ 3 days (OR = 2.963, 95% CI = 1.282 - 6.852), limb immobilization (OR = 2.843, 95% CI = 1.209 - 6.685), FIB (OR=57.765, 95% CI = 11.308 - 295.094), and D-D (OR = 3.415, 95% CI = 1.396 - 8.359) (P < 0.05). Overall, there were statistical differences in the TT, APTT, FIB, and D-D indicators, as well as time and interaction among the study group's children (P < 0.05). Before catheterization, there was no statistically significant difference in TT, APTT, FIB, and D-D between the two groups of children (P > 0.05). Compared between groups, the TT, APTT, FIB, and D-D at T1 and T2 in the study group were significantly lower than those in the control group, while lower limb crSaO2 was significantly higher than in the control group (P < 0.05). Intra-group comparison showed statistically significant differences in TT, APTT, FIB, and D-D between the two groups of children (P < 0.05). The incidence of DVT-related symptoms in the study group was significantly lower than in the control group (P < 0.05). Conclusions: After deep vein catheterization, critically ill children are prone to be affected by extended bed rest and limb immobilization, resulting in the passive activation of the fibrinolytic system. Moreover, multidisciplinary team collaborative nursing measures based on NIRS technology can effectively improve coagulation function and lower limb oxygen saturation, thereby avoiding the occurrence of DVT-related symptoms.

Effects of different doses of alfentanil on cardiovascular response to rapid sequence intubation in elderly patients: a parallel-controlled randomized trial

BackgroundRapid sequence intubation (RSI) have been shown to be effective in preventing reflux aspiration in patients with a full stomach during anaesthesia induction and endotracheal intubation. However, there is currently no standardized operation protocol or anaesthesia induction drug standard for RSI. Furthermore, there is a lack of evidence regarding the use of RSI in patients older than 65. In this study, we aimed to investigate the cardiovascular effects of different doses of alfentanil combined with propofol and etomidate during RSI in elderly patients aged 65–80 years.MethodsA total of 96 patients aged 65–80 years who underwent general anaesthesia with tracheal intubation were selected for this study. The patients were randomly assigned to one of four groups using a random number table. Group A patients received an induction dose of 10 µg/kg alfentanil, group B patients received 15 µg/kg alfentanil, group C patients received 20 µg/kg alfentanil, and group D patients received 25 µg/kg alfentanil. Heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), and ejection fraction (EF) were measured at three time points: 5 min before anaesthesia induction (T0), 1 min after endotracheal intubation (T1), and 5 min after endotracheal intubation (T2). Concurrently, 4 ml of arterial blood was collected from patients at three time points, and the concentrations of norepinephrine (NE) and cortisol (Cor) in plasma were detected. Occurrences of hypertension, hypotension, bradycardia and tachycardia during anesthesia induction to 5 min after tracheal intubation were noted.ResultsCompared with T0, the HR, MAP, NE and Cor concentrations in group A and group B were increased at the T1 and T2 time points, CI and EF values were decreased (P < 0.05). HR and MAP in groups C and D were increased at the T1 time point, while they were decreased at the T2 time point in group D (P < 0.05). The changes in CI and EF values, concentrations of NE and Cor, were not significant at T1 and T2 time points in group C (P > 0.05). Additionally, they were not significant in group D at the T1 time point (P > 0.05), but decreased at the T2 time point (P < 0.05). Compared with group A, the HR, MAP, NE and Cor concentrations in groups C and D were decreased at T1 and T2 time points (P < 0.05). The CI and EF values of groups C and D were increased at T1 time point but decreased at T2 time point in group D (P < 0.05). The incidence of hypertension and tachycardia in group A was significantly higher than that in group C and group D (P < 0.05), and the incidence of hypotension and bradycardia in group D was significantly higher than that in group A and group B (P < 0.05).ConclusionAlfentanil 20 µg/kg for RSI in elderly patients, can effectively inhibit the violent cardiovascular reaction caused by intubation, and avoid the inhibition of cardiovascular system caused by large dose, hemodynamics more stable.Trial registrationChiCTR2200062034 (www.chictr.org.cn).

Evaluation of oxygen administration in cesarean section under spinal anesthesia via lung ultrasound and the oxygen reserve index

BackgroundRespiratory functions may be impaired in cesarean section (C/S) delivery performed under spinal anesthesia (SA) and oxygen supplementation may be required. Therefore, we conducted a randomized controlled study aimed to evaluate the effects of different oxygen administrations in pregnant women on the lungs during C/S under SA using ultrasound and oxygen reserve index (ORI).MethodsWe conducted a randomized, controlled, single-center study from May 1, 2021, to March 31, 2022. A total of 90 patients scheduled for C/S under SA were randomly divided into 3 groups. Following the SA, patients in group 0 were treated with room air, in Group 3 were administered 3 L/min O₂ with a nasal cannula (NC), in Group 6 were administered 6 L/min O₂ with a simple face mask. In addition to routine monitoring, ORI values were measured. Lung aeration was evaluated through the modified lung ultrasound score (LUS) before the procedure (T0), at minute 0 (T1), 20 (T2), and hour 6 (T3) after the procedure, and ∆LUS values were recorded.ResultsAfter SA, the ORI values of Group 3 were higher than Group 0 at all times (p < 0.05), while the intraoperative 1st minute and the 10th, 25th and 40th minutes after delivery (p = 0.001, p = 0.027, p = 0.001, p = 0.019) was higher than Group 6. When the LUS values of each group were compared with the T0 values a decrease was observed in Group 3 and Group 6 (p < 0.001, p = 0.016). While ∆LUS values were always higher in Group 3 than in Group 0, they were higher only in T1 and T2 in Group 6.ConclusionWe determined that it would be appropriate to prefer 3 L/min supplemental oxygen therapy with NC in C/S to be performed under SA.

Efficacy of Tilt-Angle and Low-Dose CT Scan Guidance in Percutaneous plasma Radiofrequency Treatment for Lumbar 5-Sacrum 1 Disc Herniation.

To investigate the application effect of tilt-angle low-dose ComputedTomography (CT) scanning guidance technology in the plasma radiofrequency treatment of lumbar 5-sacrum 1 (L5-S1) intervertebral disc herniation. A total of 43 patients with L5-S1 disc herniation were included in this study and categorized into vertical-angle-guided CT (Group A, n = 21) and tilt-angle-guided CT (Group B, n = 22) groups. Percutaneous plasma L5-S1 disc radiofrequency treatment was administered. The total number of punctures and scans, operation times, and Numerical Rating Scale (NRS) pain scores (preprocedure and 3 and 30 days postprocedure) were documented. Compared with Group A, punctures and scans were fewer in Group B, and the differences were statistically significant (P = 0.0001). Moreover, the CT scan-guided total surgery time was significantly shorter in Group B than in Group A (P = 0.0001). In addition, the NRS score exhibited a statistically significant difference among preprocedure (T0), 3 day postprocedure (T1), and 30 days (T2) in Groups A (P < 0.05). The NRS score exhibited a statistically significant difference between T0 and T1 and between T0 and T2 in Group B (P < 0.05), but not between T1 and T2 in Group B (P = 0.084). At three time points (T0, T1, T2), there was no statistically significant difference between the two groups (P > 0.05). The tilt-angle low-dose CT scanning technique for L5-S1 disc herniation offers the advantages of high efficiency, low damage, and low radiation, and its clinical application is recommended.

The effect of educational animation compared to leaflets on patients’ knowledge regarding root canal treatment: a randomized controlled trial

BackgroundIncorporating video as a tool for education offers a multitude of advantages. However, it is unknown what is the best educational tool to use for increasing public awareness, consequently reducing fear about root canal treatment. For this reason, this study aimed to compare the effectiveness of educational animation and leaflets as delivery methods for providing information on root canal treatment to patients and to assess their ability to retain the information.MethodsOne hundred fifty adult volunteers were recruited via social media and Umm Al-Qura University Dental Hospital to participate in this randomized control trial study. The volunteers were divided into the study group (SG) and the control group (CG). The SG was provided with information through animations created by the research team, while the CG received the same information through a leaflet. Pre-intervention (T1), immediate post-intervention (T2), and one-month post-intervention (T3) validated questionnaires were completed by the participants to assess the changes in their knowledge. To evaluate the impact of the information delivery method, the knowledge scores of T2 and T3 were compared to T1 within each group using Paired T-tests. Additionally, the study compared the knowledge scores of the two groups using unpaired T-tests. The significance level was set at a P-value of less than 0.05.ResultsA significant improvement in endodontic therapy knowledge among the participants in both groups (T1 compared to T2 in the same group) was noted (P < 0.050). However, when comparing T2 between groups, no significant difference was found in delivering the information and improving the knowledge (P = 0.080). Still, the mean differences between T1 and T2, as well as T1 and T3, were greater (P < 0.050) in the SG than in the CG. Furthermore, the total knowledge score in the SG at T3 was significantly higher than the CG.ConclusionBoth educational animation and leaflets are practical tools to increase patients’ awareness about root canal treatment. However, educational videos are more effective than leaflets in delivering and retaining information about root canal treatment.Trial registrationThis study was retrospectively registered as a randomized control trial at the ISRCTN registry with the document number ISRCTN18413241, 15/05/2023.

Application of hip capsule peripheral nerve block in early analgesia in elderly patients with hip fracture.

The objective of the study is to investigate the effect of pericapsular nerve group (PENG) block in early analgesia in elderly patients with hip fracture. A total of 44 elderly patients with hip fracture admitted to our hospital from August 2021 to December 2022 were selected and divided into 2 groups according to different analgesia programs. At T1~T4, the resting and active visual analog scale (VAS) scores in group P were lower than group F (p < 0.05). The resting and active VAS scores at T5 in both groups were no visible differences (p > 0.05). After 30 min of block, systolic blood pressure, diastolic blood pressure, and heart rate were decreased in both groups (p < 0.05), but no obvious difference was found in the two groups (p > 0.05). Before surgery, Pittsburgh Sleep Quality Index (PSQI) and mini-mental state scale (MMSE) scores in both groups were reduced, and PSQI score in group P was lower than that in group F and MMSE score was higher than group F (p < 0.05). PENG technology is safe and effective in the early analgesia of elderly hip fractures. It can effectively block physiological stress response caused by acute trauma, improve pre-operative sleep quality, and reduce the incidence of cognitive dysfunction.

Immediate effects of TECAR therapy on lower limb to decrease hypertonia in chronic stroke survivors: a randomized controlled trial

Purpose To analyze immediate effects of TECAR therapy (TT) to reduce lower limb hypertonia and improve functionality in chronic post-stroke. Materials and methods It is a single-blind randomized controlled clinical trial. A total of 36 chronic stroke survivors were divided into two groups. The experimental group received a single 30-minute session of TT with functional massage (FM) on lower limb. The control group received a single 30-minute session sham treatment of TT plus FM. The primary outcome measure was hypertonia (Modified Ashworth Scale, MAS). Secondary outcomes were gait speed (4-Meter Walk-Test), standing knee-flexion (Fugl-Meyer Assessment Scale IV-item), change in weight bearing ankle dorsiflexion (Ankle Lunge Test, ALT), and functional lower limb strength (5-Times Sit-to-Stand Test). All measurements were performed at baseline, immediately and 30-minutes after treatment. Results There was a group–time interaction in MAS-knee (p = 0.044), MAS-ankle (p = 0.018) and ALT (p = 0.016) between T1 and T0 (p<.0001) and T2 and T0 (p<.0001) for the experimental group. There was a significant increase in ALT between T1 and T0 (p = 0.003) in the control group. Conclusions A single session of TT performed at the same time as FM immediately reduces plantar-flexors and knee-extensor muscle hypertonia and increases change in weight bearing ankle dorsiflexion in chronic stroke survivors.

P-498 Multicentre two-arm randomised controlled trial of Beyond Fertility: A brief face-to-face psychosocial intervention to promote patients’ healthy adjustment when ending unsuccessful fertility treatment

Abstract Study question Is Beyond Fertility effective in ameliorating the negative impact of ending unsuccessful fertility treatment (EoT) on patients’ quality of life? Summary answer Patients allocated to Beyond Fertility (intervention group) reported higher quality of life six months after EoT than patients allocated to care as usual (control group). What is known already Around four in every ten patients end all IVF/ICSI treatment cycles without achieving a live birth (referred as EoT). Recent mixed-methods research indicates 93.3% of patients want to be prepared for and supported through EoT. Two interventions have been proven to improve the wellbeing of people with an unfulfilled wish for children after they proactively started trying to conceive, but, to our knowledge, no intervention focused on preparing and supporting fertility patients through this experience. Following the Medical Research Council guidelines, we developed Beyond Fertility, a face-to-face psychosocial intervention integrating preventive with early-interventive care to ease patients’ adjustment during EoT. Study design, size, duration Multicentre two-arm parallel-group open-label RCT with 1:1 allocation to intervention (Beyond Fertility) or control (usual mental-healthcare at participating clinics, CaU). Beyond Fertility includes seven therapeutic sessions: one (individual/couple) within one month the last IVF/ICSI cycle (preventive care) and six (individual/couple and group) sessions after EoT (early-interventive care). Participants self-reported on quality-of-life one month before their last reimbursed IVF/ICSI cycle (T1, pre-session 1), two weeks (T2, post-session 1) and six months (T4, post-intervention) after cycle ended. Participants/materials, setting, methods Women patients were consecutively screened and invited to participate with their partners at four public fertility centres in Portugal (Dez 2021-Mar 2023). Inclusion criteria were being adults scheduled to initiate their last reimbursed IVF/ICSI cycle within one month. Primary outcome was quality-of-life, self-reported online with FertiQoL (Melo et al., 2012). Linear-mixed-effect models compared changes in quality-of-life from T1 to T2 and T4 in intervention and control groups. Outcome data were reported for modified intention-to-treat (mITT). Main results and the role of chance From 143 eligible women(90.51% eligibility rate), 74(51.75% consent rate) and 41 partners completed T1 assessment(N=115) and were allocated to Beyond Fertility(n=60) or CaU(n=55). Average age was 38 years. Sixty-four percent were women, 62% had university education, 92% were employed, all were in a heterosexual relationship, and 30% had children. Participants were undergoing treatment for around three years. Fourteen(14.14%) achieved a pregnancy in their last reimbursed IVF/ICSI cycle, 34(34.34%) did not achieve a pregnancy and ended treatment (i.e. faced EoT), and 51(51.52%) did not achieve a pregnancy and continued treatment. Among participants who were allocated to Beyond Fertility and faced EoT, eight(44.44%) withdrew from its early-interventive care mainly due to not accepting the group format, and only four(22.22%) received the full intervention due to practicality issues. Among participants who faced EoT, participation rates for Beyond Fertility and CaU groups were 88.89%(n=16) and 100%(n=16) at T2, and 77.78%(n=14) and 93.75%(n=15) at T4, respectively. Among these participants, those allocated to Beyond Fertility had an estimated mean quality-of-life score around 6 points higher than participants allocated to CaU at T2 (β=6.17, p=0.113) and around 9 points higher (almost one standard deviation above the baseline mean of the total sample) at T4 (β=8.95, p=0.035). Limitations, reasons for caution The trial was not blind, and therefore, response bias cannot be ignored. Attrition was slightly higher in the Beyond Fertility than the CaU group, suggesting that mITT may marginally overestimate the effect of Beyond Fertility. Wider implications of the findings Structured psychosocial care that starts during treatment and continues in its aftermath to support patients who end treatment without achieving pregnancy is effective in ameliorating declines in quality-of-life, suggesting it can ease adjustment during this difficult life transition. Benefits may be maximised by tailoring it to patients’ preferred delivery format. Trial registration number ISRCTN Registry ISRCTN85897617

Effectiveness and safety of multimodal analgesia in open gastrostomy in patients with end-stage head and neck cancer

Objective: To investigate the effectiveness and safety of multimodal analgesia in patients with end-stage head and neck cancer in open gastrostomy surgery. Methods: This was a randomized controlled trial. From June to December 2023, 50 patients with end-stage head and neck cancer who underwent elective open gastrostomy surgery in Beijing Tongren Hospital Affiliated to Capital Medical University were prospectively selected. The patients were divided into multimodal analgesia group and local anesthesia group using the random number table method according to different anesthesia methods, with 25 cases in each group. In multimodal analgesia group, a multimodal analgesia regimen was adopted: ultrasound-guided abdominal wall nerve block (rectus sheath block and transverse abdominis plane block)+intravenous injection of oxycodone+intravenous injection of flurbiprofen axetil and dexamethasone. In local anesthesia group, local infiltration anesthesia with ropivacaine was adopted. The main outcome measure was the incidence of intraoperative pain numeric rating scale (NRS) score>3 points in the two groups. The secondary observation indicators included NRS score and hemodynamic indexes [mean arterial pressure (MAP) and heart rate (HR)] at various time points during surgery [before anesthesia (T0), at the time of incision (T1), 10 minutes after surgery (T2), during gastric body traction (T3), and at the end of surgery (T4)], incidence of adverse reactions, postoperative patient satisfaction score, as well as the NRS scores at rest and activity (coughing) within 24 hours after surgery. Results: The multimodal analgesia group included 21 males and 4 females, aged (61.4±9.9) years. There were 19 males and 6 females in the local anesthesia group, aged (58.6±10.8) years. The incidence of intraoperative NRS score>3 points and the incidence of salvage analgesia in the multimodal analgesia group were both 12.0% (3/25), which were lower than 60.0% (15/25) in the local anesthesia group, and the differences were statistically significant (all P<0.001); The NRS score [M (Q1, Q3)] at T3 in the multimodal analgesia group was 2 (2, 3) points, which were lower than 5 (3, 6) points in the local anesthesia group (P<0.05). There were smaller variabilities in MAP and HR in the multimodal analgesia group than those in the local anesthesia group (all P<0.05). The incidence of intraoperative tachycardia, surgical traction reaction, and nausea in the multimodal analgesia group was lower than that in the local anesthesia group (all P<0.05). The postoperative satisfaction score of patients in the multimodal analgesia group was (9.25±0.71) points, which were higher than (7.33±0.87) points in the local anesthesia group (P<0.001). NRS score during postoperative activity within 24 hours in the multimodal analgesia group were (2.36±0.75) points, which were lower than (3.03±0.81) points of the local anesthesia group (P=0.005). No adverse reactions such as urinary retention, nausea, vomiting and dizziness occurred in both groups. Conclusion: Compared with local anesthesia, the multimodal analgesic strategy could provide better analgesic effect and longer duration, better hemodynamic stability, and fewer intraoperative adverse reactions in patients with end-stage head and neck cancer undergoing open gastrostomy.

Development of an animal model of hypothyroxinemia during pregnancy in Wistar rats

AbstractBackgroundHypothyroxinemia is a subclinical thyroid hormone deficiency in which the mother has inadequate levels of T4 during pregnancy. The fetus relies entirely on the mother's T4 hormone level for early neurodevelopment. Isolated maternal hypothyroxinemia (IMH) in the first trimester of pregnancy can lead to lower intelligence, lower motor scores, and a higher risk of mental illness in descendants. Here, we focus on the autism‐like behavior of IMH offspring.MethodsThe animals were administered 1 ppm of propylthiouracil (PTU) for 9 weeks. Then, the concentrations of T3, T4, and thyroid‐stimulating hormone (TSH) were detected using enzyme‐linked immunosorbent assay (ELISA) to verify the developed animal model of IMH. We performed four behavioral experiments, including the marble burying test, open‐field test, three‐chamber sociability test, and Morris water maze, to explore the autistic‐like behavior of 40‐day‐old offspring rats.ResultsThe ELISA test showed that the serum T3 and TSH concentrations in the model group were normal compared with the negative control group, whereas the T4 concentration decreased. In the behavioral experiments, the number of hidden marbles in the offspring of IMH increased significantly, the frequency of entering the central compartment decreased, and the social ratio decreased significantly.ConclusionThe animal model of IMH was developed by the administration of 1 ppm of PTU for 9 weeks, and there were autistic‐like behavior changes such as anxiety, weakened social ability, and repeated stereotyping in the IMH offspring by 40 days.

Effects of tramadol hydrochloride preemptive analgesia in kyphoplasty of thoracolumbar osteoporotic fractures under local anesthesia

To explore preemptive analgesic effect of preoperative intramural tramadol injection in percutaneous kyphoplasty (PKP) of vertebrae following local anesthesia. From August 2019 to June 2021, 118 patients with thoraco lumbar osteoporotic fractures were treated and divided into observation group and control group, with 59 patients in each gruop. In observation group, there were 26 males and 33 females, aged from 57 to 80 years old with an average of (67.69±4.75)years old;14 patients on T11, 12 patients on T12, 18 patients on L1, 15 patients on L2;tramadol with 100 mg was injected intramuscularly half an hour before surgery in observation group. In control group, there were 24 males and 35 females, aged from 55 to 77 years old with an average of (68.00±4.43) years old;19 patients on T11, 11 patients on T12, 17patients on L1, 12 patients on L2;the same amount of normal saline was injected intramuscularly in control group. Observation indicators included operation time, intraoperative bleeding, visual analogue scale (VAS) evaluation and recording of preoperative (T0), intraoperative puncture(T1), and working cannula placement (T2) between two groups of patients, at the time of balloon dilation (T3), when the bone cement was injected into the vertebral body (T4), 2 hours after the operation (T5), and the pain degree at the time of discharge(T6);adverse reactions such as dizziness, nausea and vomiting were observed and recorded;the record the patient's acceptance of repeat PKP surgery. All patients were successfully completed PKP via bilateral pedicle approach, and no intravenous sedative and analgesic drugs were used during the operation. There was no significant difference in preoperative general data and VAS(T0) between two groups (P>0.05). There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). VAS of T1, T2, T3, T4 and T5 in observation group were all lower than those in control group(P<0.05), and there was no significant difference in T6 VAS (P>0.05). T6 VAS between two groups were significantly lower than those of T0, and the difference was statistically significant (P<0.05). There was no significant difference in incidence of total adverse reactions between two groups (P>0.05). There was a statistically significant difference in the acceptance of repeat PKP surgery (P<0.05). Half an hour before operation, intramuscular injection of tramadol has a clear preemptive analgesic effect for PKP of single-segment thoracolumbar osteoporotic fracture vertebral body under local anesthesia, which could increase the comfort of patients during operation and 2 hours after operation, and improve patients satisfaction with surgery.

Effectiveness of Ultrasound Therapy, TheraBiteDevice, Masticatory Muscle Exercises, and Stabilization Splint for the Treatment of Masticatory Myofascial Pain: A Randomized Controlled Trial.

Myofascial pain syndrome (MPS) is a particular type of temporomandibular joint disorder. Research findings comparing various treatment approaches are scarce and controversial. Therefore, this study aimed to compare the effectiveness of ultrasound therapy, stabilization splint, TheraBitedevice, and masticatory muscle exercises in reducing pain intensity and improving mandibular mobility in patients with MPS. It was a single-blind, randomized, parallel-group, active-controlled trial that took place between April 2023 and October 2023 at the Department of Fixed Prosthodontics, Damascus University. Patients older than 18 years old with myofascial pain accompanied by limited jaw opening and pain lasting for at least 6 months were included. Eighty patients were randomly assigned into four groups using online randomization software: ultrasound therapy, stabilization splint, TheraBitedevice, and masticatory muscle exercises. Only outcome assessors were masked totreatment allocation. The exercise regimen was the exercise program for patients with TMD. The following primary outcome measures were considered at the baseline (t0), at the first (t1), second (t2), and fourth (t3) week of treatment, and at the second (t4) and fifth (t5) month of follow-up: pain intensity using the visual analogue scale, maximum interincisal opening, right lateral movement, and left lateral movementmeasured in millimeters. The pain level changed from severe to mild at t3 in ultrasound therapy, stabilization splint, and TheraBitedevice groups. In the masticatory muscle exercises group, it changed to moderate, with a significant difference between ultrasound therapy (p = 0.012) and stabilization splint (p = 0.013) groups. In addition, the mandibular mobility continued to improve at the subsequent follow-up periods (t4 and t5). All therapies are equally effective after 5-month follow-up. However, ultrasound therapy and stabilization splints have the benefit of achieving rapid improvement. ISRCTN20833186.