Τρίτη 3 Μαΐου 2022

The effectiveness of esketamine and propofol versus dezocine and propofol sedation during gastroscopy: A randomized controlled study

alexandrossfakianakis shared this article with you from Inoreader
The effectiveness of esketamine and propofol versus dezocine and propofol sedation during gastroscopy: A randomized controlled study

This is a flow diagram showing enrollment of participants. A total of 102 patients were enrolled in this study from October to November 2021, 15 patients were excluded, and 87 patients were randomly assigned to receive esketamine or dezocine, but 83 patients completed the study finally (esketamine group n = 42, dezocine group n = 41).


Abstract

What Is Known and Objective

Propofol is widely used in painless gastroscopy. However, sedation with propofol alone might increase the risk of respiratory and circulatory complications. This randomized clinical study compares the efficacy and safety of esketamine or dezocine combined with intravenous (IV) propofol in patients undergoing gastroscopy.

Methods

A total of 102 patients were enrolled in this study and randomized into two groups. All patients were adults aged 18–64 years who underwent upper gastrointestinal gastroscopy. Patients were randomly assigned to two groups to receive esketamine (0.3 mg/kg) combined with propofol (group E) or dezocine (0.05 mg/kg) combined with propofol (group D). In both groups, the drugs were administered intravenously. The primary outcome was the dose of propofol which provided a satisfactory sedative effect, both to the endoscopist and the patients. Secondary outcomes included recovery time, side effects (such as hypotension, nausea and vomiting and agitation), and the number of adverse circulatory and respiratory events.

Results

Data of 83 patients were analysed in the present study. Dosage of propofol required in group E (1.44 mg/kg ± 0.67 mg/kg) was significantly lower compared with that in group D (2.12 mg/kg ± 0.37 mg/kg) (p < 0.0001). There was no statistically significant difference in recovery time, side effects, and the frequency of sedation-related adverse events between the two groups.

What Is New and Conclusion

The study indicates that intravenous injection of propofol and esmketamine is more effective for gastroscopy. Use of esketamine reduces the total amount of propofol required in ASA I–II patients undergoing gastroscopy compared with single use of dezocine. It also provides more stable hemodynamics, without affecting the recovery time and side effects such as respiratory and circulatory adverse events.

Trial Registration

The study was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn; registration number: ChiCTR2100051814) on 05/10/2021.

View on the web

HIV is associated with elevated FibroScan-AST (FAST) score

alexandrossfakianakis shared this article with you from Inoreader

cid_ogimage.png

Abstract
Background & Aims
Whether HIV infection is associated with the development of nonalcoholic steatohepatitis (NASH) remains unclear. The FibroScan-AST (FAST) score was developed to identify patients who have histologic NASH with high nonalcoholic fatty liver disease activity score (NAS≥4) and significant liver fibrosis (≥F2), which has been associated with higher risk of end-stage liver disease. We examined whether HIV infection is associated with elevated FAST score in a large United States (US) cohort.
Approach
Vibration controlled transient elastography was performed in 1309 women without history of chronic viral hepatitis enrolled from 10 US sites: 928 women living with HIV (WLWH) and 381 women living without HIV (WLWOH). We used multivariable logistic regression to evaluate associations of HIV, demographic, lifestyle, and metabolic factors with an elevated (>0.35) FAST score.
Results
Median age of WLWH and WLWOH was 51 years and 48 years, respectively. Most (90%) WLWH were on antiretroviral therapy and 72% had undetectable HIV RNA. Prevalence of elevated FAST score was higher among WLWH compared to WLWOH, 6.3% vs 1.8% (p=0.001). On multivariable analysis, HIV infection was associated with 3.7-fold higher odds of elevated FAST score (p=0.002) and greater waist circumference (per 10 cm) was associated with 1.7-fold higher odds (p<0.001). In analysis limited to WLWH, undetectable HIV RNA and current protease inhibitor use were independently associated with lower odds of elevated FAST score.
Conclusions
Our findings suggest that HIV is an independent risk factor for NASH with significant activity and fibrosis. Studies validating FAST score in persons living with HIV are warranted.
View on the web

Hydroxyl radical is predominantly involved in oxidatively generated base damage to cellular DNA exposed to ionizing radiation

alexandrossfakianakis shared this article with you from Inoreader
.
View on the web

Treatment planning comparison in the PROTECT-trial randomising proton versus photon beam therapy in oesophageal cancer: results from eight european centres

alexandrossfakianakis shared this article with you from Inoreader

1-s2.0-S0167814022X00030-cov150h.gif

Publication date: Available online 2 May 2022

Source: Radiotherapy and Oncology

Author(s): Lone Hoffmann, Hanna Mortensen, Muhammad Shamshad, Maaike Berbee, Nicola Bizzocchi, Rebecca Bütof, Richard Canters, Gilles Defraene, Mai Lykkegaard Ehmsen, Francesca Fiorini, Karin Haustermans, Ryan Hulley, Erik W. Korevaar, Matthew Clarke, Sebastian Makocki, Christina T. Muijs, Luke Murray, Owen Nicholas, Marianne Nordsmark, Ganesh Radhakrishna

View on the web

The effect of (-)-epigallocatechin gallate as an adjunct to non-surgical periodontal treatment: a randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader

13063.jpg

EGCG is proven to be of good effect to relieve periodontal inflammation, but it has not been applied as a local delivery medicine in patients with periodontitis widely. The aim of this clinical trial was to ev...
View on the web