Abbott (Sweden)

This study aimed to describe and compare postoperative pain patterns associated with two commonly used pre-incisional analgesic practices: intravenous paracetamol and port-site infiltration of 0.5% ropivacaine in patients undergoing laparoscopic cholecystectomy. This observational study included 68 adult patients undergoing elective laparoscopic cholecystectomy under general anesthesia between December 2019 and April 2021. Ethical approval was obtained, and informed consent was secured from all participants. According to routine anesthetic practice, patients received either pre-incisional intravenous paracetamol (Group P, n = 34 (50%)) or port-site infiltration with 0.5% ropivacaine (Group R, n = 34 (50%)). Postoperative pain was assessed using the visual analog scale (VAS) at defined postoperative time points, and the need for rescue analgesia and the incidence of postoperative nausea and vomiting (PONV) were recorded. A total of 68 patients were analyzed, with comparable baseline characteristics between the intravenous paracetamol and port-site ropivacaine groups (mean age 42.5 ± 12.2 years; females 64.7%). Postoperative pain was observed in 48 (70.6%) patients, with a similar distribution between the two groups. Mean VAS scores declined from 7.55 ± 0.75 at 0 hour to 3.15 ± 1.4 at 24 hours in both groups. Rescue analgesia within 24 hours was required in 30 (44.1%) patients, more frequently in the intravenous paracetamol group (58.8%) than the port-site ropivacaine group (29.4%). Logistic regression showed higher, but non-significant, odds of rescue analgesia with intravenous paracetamol (OR 2.25; 95% CI 0.92-5.50). Pre-incisional intravenous paracetamol combined with port-site infiltration of ropivacaine produces a predictable postoperative pain trajectory following laparoscopic cholecystectomy. Although the specific effect of port-site ropivacaine on local incision pain could not be isolated, the intervention contributes to overall pain control. No clear predictors of rescue analgesia were identified. These findings highlight the importance of incorporating site-specific analgesia into a broader multimodal pain management strategy to optimize postoperative comfort.

The treatment of calcified coronary lesions requires optimal lesion preparation to achieve a larger minimal stent area (MSA), the strongest predictor of long-term outcomes. The comparative mechanisms of action of calcium-modifying therapies have not been well defined. In a prospective, multicenter ECLIPSE trial (Evaluation of Treatment Strategies for Severe Calcific Coronary Arteries: Orbital Atherectomy Versus Conventional Angioplasty Technique Before Implantation of Drug-Eluting Stents), 2005 patients with severely calcified lesions were randomized to vessel preparation with orbital atherectomy (OA) versus balloon angioplasty (BA) before drug-eluting stent implantation. The primary end point of the optical coherence tomography (OCT) substudy was the MSA at the site of maximal calcification; MSA across the entire stent was also assessed. Postprocedural OCT images were available in 286 lesions in 276 patients treated with OA and 292 lesions in 279 patients treated with BA. By angiographic core laboratory analysis, 567 (98.1%) of lesions were severely calcified. By postprocedural OCT, the maximal calcium arc, maximal calcium thickness, and total calcium length measured 204° (149°-268°), 0.85 mm (°0.69-1.03°), and 22.0 (16.0-31.0) mm. Compared with BA, calcium modification was greater in the OA group (greater number, total length, and maximal depth of calcium fractures), especially in lesions with thicker calcium. Nonetheless, the MSA at the site of maximal calcification was large in both groups and not different (median [interquartile range], 7.44 [6.03-8.94] mm2 versus 7.05 [5.78-8.66] mm2; P=0.08). Similar results were observed for the MSA across the entire stent (5.86 [4.60-7.38] mm2 versus 5.57 [4.50-6.97] mm2; P=0.10). Among patients in the OCT substudy, 1-year target-vessel failure rates were low and not different between the groups (7.8% with OA and 6.6% with BA, P=0.61). In lesions that are severely calcified by angiography, the extent of calcification by OCT was highly variable. Despite greater calcium modification after OA, the acute MSA and 1-year target-vessel failure rates were not different between OA and BA. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03108456.

Introduction: Maintenance of oral hygiene is very important for orthodontic patients to save them from the conditions that negatively affect their oral health and for this reason patients should be motivated using different motivational methods. Objective: To determine the effect of pre-treatment dental photographs on maintenance of oral hygiene in orthodontic patients using standardized plaque index. Materials and Methods: It was a randomized controlled trial. A total of 60 patients were randomized into two groups with 30 patients in each group. Patients in Group A were shown their full extra- and intra-oral photographs, while patients in Group B were shown no photographs. Improvement in oral hygiene was measured through plaque index recorded on first visit (T0) using University of Michigan ‘O’ probe with Williams’s markings. Plaque index was again recorded after 3 months (T1). Modified Silness-Loe plaque index was used in this study. Results: Intra-group comparison through paired sample t-test showed significant reduction in plaque index (p=0.001), while inter-group comparison performed through independent sample t-test showed statistically insignificant difference (p=0.174) Stratification by age groups and gender showed insignificant results in males (p=0.40 for group A and p=0.26 for group B), while in females results were significant in group A (p=0.001), and insignificant in group B (p=0.10). Conclusion: This study concluded that showing pre-treatment dental photographs (extra-oral and intra-oral) to the orthodontic patients has no effect in improving their oral hygiene status. (Clinical trial registration: ID number NCT06010797)

The purpose of this retrospective case series is to describe real-world clinical experience with DermaBind TL or FM, (HealthTech Wound Care, US), a dehydrated full-thickness placental membrane intended for homologous use as a protective wound covering in wounds of various aetiologies that failed to heal with standard of care (SoC). This retrospective observational, uncontrolled case series collected data from healthcare providers in the US. Eligible cases were patients, ≥18 years of age, with hard-to-heal wounds who received DermaBind TL or FM after having completed a minimum of four weeks of SoC without evidence of wound improvement. Data collected included patient demographics, wound characteristics and wound size. The cases of 27 patients encompassing 36 wounds were included. The average age of patients included was 72.4 years (range: 37-101 years). The majority of wounds were pressure ulcers (63.9%), followed by diabetic foot ulcers (19.4%) and venous leg ulcers (8.3%). Wound onset was, on average, 29 weeks prior to the first graft application with the placental membrane, and the average wound size was 34cm2. Graft applications occurred weekly, with an average duration of treatment of 6.7 weeks. The observed average percentage surface area reduction across the 36 wounds was 69.1% (range: -17.6-100%). No adverse events were reported by the provider across all patient cases. These observations describe the clinical use of DermaBind as a wound covering material consistent with its homologous natural protective role. Larger, prospective studies are warranted to further investigate its clinical use. The authors would like to stress that this non-randomised, retrospective uncontrolled case series was used to describe findings, such as number of grafts applied, observed percentage of surface area reduction and graft wasted, and not to demonstrate efficacy.

The SELEX process to identify RNA and DNA aptamers relies on sequencing selection rounds to detect highly specific aptamers through patterns of aptamer accumulation or enrichment. However, this approach infers rather than quantify aptamer specificity. Here we present a novel strategy for directly quantifying aptamer specificity within enriched libraries termed Aptamer Specificity Sequencing for Efficient Targeting (ASSET). The ASSET framework takes experimental samples and replicates testing the specificity of an aptamer library and prepares them for next-generation sequencing (NGS) with a known internal reference sequence. This enables robust data normalization, calculation of aptamer specificity scores with statistical significance, and the creation of specificity profiles of individual aptamers across multiple targets and non-targets. By integrating ASSET specificity scores with conventional selection round sequencing data, aptamers can be easily classified as true or false positives and negatives, allowing for easy separation of true positive aptamers. Compared to conventional methods for identifying aptamer candidates, such as measuring abundance or enrichment, ASSET specificity scores show a strong correlation with experimentally measured specificity. This supports ASSET as a more effective metric for selecting lead candidates following SELEX. ASSET is an easily implemented framework that accelerates the identification of highly specific aptamers, thereby expediting aptamer discovery for therapeutic and diagnostic applications.

Background: The rising rates of cesarean sections (CS) globally have increased the number of women with prior cesarean deliveries who may be candidates for vaginal birth after cesarean (VBAC). This study explores the factors influencing the success of VBAC in women with a previous CS and fetomaternal complications associated with VBAC failure.Methods: This cross-sectional study was conducted at the obstetrics unit of Ayub Teaching Hospital, Abbottabad, Pakistan, enrolling 102 eligible women who had previously undergone a CS and were offered the option of attempting a vaginal delivery. Demographic, clinical, and obstetric data were collected on a predesigned proforma. The success of VBAC was defined as a vaginal delivery without the need for an emergency cesarean section. Statistical analysis was done using IBM SPSS Statistics software, version 27.0 (IBM Corp., Armonk, NY).Results: Participants had a mean age of 30.36 ± 2.07 years and a mean body mass index (BMI) of 25.71 ± 0.90 kg/m². The overall VBAC success rate was 79.4% (n=81), with a failure rate of 20.6% (n=21). Maternal complications, including infection and the need for blood transfusion, were significantly higher in the VBAC failure group. Fetal outcomes also showed that VBAC failures were more likely to result in an Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score <7 at 10 minutes (P=0.006). Similarly, maternal complications were significantly higher in VBAC failures (5/21, 23.8%) than successes (3/81, 3.7%; P=0.009). On regression analysis, VBAC failure was found to be an independent predictor of both fetal complications (with an odds ratio of 14.610 (95% CI: 1.290-165.421, p = 0.030)) and maternal complications (with an odds ratio of 8.767 (95% CI: 1.762-44.535, p = 0.009)).Conclusions: VBAC is a safe and effective option for women with a prior CS, with a high success rate; however, VBAC failure was found to be an independent predictor of both fetal and maternal complications. Our findings suggest the importance of a personalized approach to VBAC assessment and counselling to optimize outcomes for women undergoing trial of labor after cesarean (TOLAC).

Aims This study evaluated the effectiveness of the Attention Skill Training (ASTride) protocol—an Equine-Assisted Occupational Therapy (EAOT) intervention—in improving participation, performance skills, and daily function among children with Attention Deficit Hyperactivity Disorder (ADHD). Methods A prospective cohort study with an Interrupted Time-Series design was conducted with 50 children (mean age = 9.51 years, Standard Deviation = 1.52) diagnosed with ADHD. Assessments were conducted at baseline (Time 1), pre-intervention (Time 2), post-intervention (Time 3), and three-month follow-up (Time 4). Measures included the Child Performance Skill Questionnaire, Child Participation Questionnaire (CPQ), and the Canadian Occupational Performance Measure (COPM). Results Using a repeated measure ANOVA revealed statistically significant improvements from Time 1 to Time 4 in everyday participation as presented in the CPQ scales of frequency, independence, enjoyment, and parental satisfaction alongside notable gains in motor, process, and communication skills. COPM scores demonstrated sustained progress in performance and satisfaction with the intervention goals. Conclusions The ASTride intervention effectively enhanced participation in everyday activities and performance skills among children with ADHD, with benefits sustained beyond the intervention period and beyond the stable setting. These findings highlight ASTride’s potential as a comprehensive, evidence-based approach to addressing ADHD-related challenges.