The management of postoperative pain in pediatric patients undergoing emergency surgical procedures, particularly in non-pediatric hospitals, presents significant challenges due to the unique physiological requirements of children. The utilization of opioid analgesia may result in severe complications, necessitating a transition toward multimodal analgesia, which integrates various pain management strategies to enhance effectiveness while mitigating adverse effects. Locoregional anesthesia techniques, such as fascial plane blocks, provide targeted pain alleviation, reducing dependence on opioids.
View Article and Find Full Text PDFThe COVID-19 pandemic has encouraged the rapid development and licensing of vaccines against SARS-CoV-2. Currently, numerous vaccines are available on a global scale and are based on different mechanisms of action, including mRNA technology, viral vectors, inactive viruses, and subunit particles. Mass vaccination conducted worldwide has highlighted the potential development of side effects, including ones with skin involvement.
View Article and Find Full Text PDFObjective: The study aimed to explore the utility of contrast-enhanced ultrasound (CEUS) as a tool for detecting minimal inflammation in rheumatoid arthritis (RA) patients in sustained remission (SR) and to correlate the findings with Disease Activity Score 28 (DAS28) status scores and various ultrasound (US) scores.
Patients And Methods: Thirty RA patients in SR (minimum 6 months), 12 with active disease, and 10 healthy controls were included. Clinical evaluations and US assessments were performed, including grayscale US (GSUS), power Doppler US (PDUS), and Global OMERACT-EULAR Synovitis Score (GLOESS).
Objective: To test the reliability of the Outcome Measures in Rheumatology Giant cell arteritis (GCA) Ultrasonography Score (OGUS) and other composite scores in a patient-based exercise involving experts and non-experts in vascular ultrasonography.
Methods: Six GCA patients were scanned twice (two rounds separated ≥3 hours) by 12 experts and 12 non-experts. Non-experts received 90 min of theoretical and 240 min of practical training between rounds 1 and 2.
RMD Open
December 2024
Background: Inflammation is increasingly recognised as a treatment target in hand osteoarthritis, and therefore correct measurement of local inflammation is essential. This study aimed to assess ultrasound scoring of synovitis and the additional value of the Global OMERACT/EULAR Ultrasound Synovitis Score (GLOESS) in hand osteoarthritis.
Methods: Data from the randomised, double-blinded Hand Osteoarthritis Prednisolone Efficacy (HOPE) trial were used.
Artificial Intelligence (AI) encompasses the development of computer systems capable of tasks typically requiring human intelligence, such as visual perception, speech recognition, decision-making, and language translation. Over time, numerous applications have emerged, with AI's integration into medicine marking a significant leap forward in healthcare delivery, diagnosis, and treatment. Among medical specialties, dermatology stands at the forefront of AI advancements, leveraging machine learning and deep learning to enhance dermatologists' abilities and improve patient care.
View Article and Find Full Text PDFBackground/objectives: The principles of value-based healthcare (VBHC) have received widespread endorsement, leading healthcare organizations worldwide to shift their strategies towards them. However, despite growing recognition and acceptance, the actual implementation of value-based approaches varies widely. This research aims to identify studies that address the implementation of VBHC at different levels (healthcare policymakers, hospital administrators, and healthcare providers), focusing on each level's relative strategies.
View Article and Find Full Text PDFThe International Staging System for multiple myeloma recently underwent a second revision (R2-ISS) to include gain/amplification of 1q21 and account for the additive prognostic significance of multiple high-risk features. The phase 3 ICARIA-MM (isatuximab-pomalidomide-dexamethasone vs. pomalidomide-dexamethasone) and IKEMA (isatuximab-carfilzomib-dexamethasone vs.
View Article and Find Full Text PDFCurrent rheumatoid arthritis (RA) treatments do not restore immune tolerance. Investigating dendritic cell (DC) populations in human synovial tissue (ST) may reveal pathways to reinstate tolerance in RA. Using single-cell and spatial transcriptomics of ST biopsies, as well as co-culture systems, we identified condition- and niche-specific DC clusters with distinct functions.
View Article and Find Full Text PDFJMIR Public Health Surveill
November 2024
This article provides a snapshot of primary prevention activities in hospitals in 20 European high-income countries, based on inputs from experts of the Observatory's Health Systems and Policies Monitor (HSPM) network using a structured questionnaire. We found that in the vast majority of countries (15), there are no systematic national policies on primary prevention in hospitals. Five countries (Cyprus, Finland, Ireland, Romania and the United Kingdom) reported systematic primary prevention activities in hospitals, although in one of them (Cyprus) this was due to the fact that small hospitals in rural areas or less populated districts host providers of primary care.
View Article and Find Full Text PDFObjectives: Advanced combination treatment (ACT), defined as a combination of at least 2 biologic agents, a biologic agent and an oral small molecule, 2 oral small molecules drug with different mechanisms of action is a proposed strategy to improve outcomes in patients with immune-mediated inflammatory disease (IMID). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ACT with monotherapy in patients with select IMIDs.
Methods: Through a systematic literature search, we identified 10 RCTs (n = 1154) comparing ACT with single agent therapy (monotherapy).
Many studies have highlighted the role of probiotics in re-establishing the gut microbiota balance and preventing intestinal barrier dysfunction. In fact, they can also contribute to the upregulation of anti-inflammatory genes and the downregulation of pro-inflammatory genes, which are known to contribute to the development of the inflammatory bowel disease (IBD) syndrome. The present study aims to investigate the effect of the compatible solute hydroxyectoine (HOE), to be used as a cryopreservant but also for its intrinsic biological properties, to obtain a new formula containing three probiotic strains ( (), SP-48 (), and HN019 ()), and evaluate the latter for its ability to prevent lipopolysaccharide (LPS)-induced inflammation in an bi-dimensional model of the intestinal barrier using a Caco-2 cell monolayer.
View Article and Find Full Text PDFThe effect of hyaluronan (HA) molecular weight (MW) and concentration (c) on key features of HA-formulations was systematically studied, in vitro, exploring the widest range/number of MW/c to date. Nine pharmaceutical grade HA samples (60-2500 kDa) were hydrodynamically characterized using Size Exclusion Chromatography-Triple Detector Array (SEC-TDA) also providing conformational data. HAs aqueous solutions (thirteen concentrations in the range 0.
View Article and Find Full Text PDFIntroduction: Subtalar arthrodesis (SA) is a common procedure to treat end-stage subtalar osteoarthritis. We set out in order to determine whether a combined direct fixation of both anterior and posterior facets during SA might influence union and complications compared to isolated fixation of the posterior facet. Our hypothesis was that a combined fixation increases the union rate and reduces the complication rate.
View Article and Find Full Text PDFBackground: Despite advancements in psoriasis treatment, a gap remains in aligning patient satisfaction with clinical outcomes. Our study aimed to evaluate which clinical and psychological factors may impact treatment satisfaction in psoriatic patients undergoing long-term biological therapies.
Methods: We performed an observational, cross-sectional, single-center study involving adult patients with moderate-to-severe psoriasis treated with biologics for at least 12 months.