Plos One
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Randomized Controlled Trial
Dexmedetomidine in combination with morphine improves postoperative analgesia and sleep quality in elderly patients after open abdominal surgery: A pilot randomized control trial.
Dexmedetomidine in combination with opioids has been used for postoperative analgesia. The purpose of this study was to investigate the impacts of dexmedetomidine supplemented intravenous analgesia on morphine consumption and subjective sleep quality in elderly patients after open abdominal surgery. ⋯ For elderly patients after open abdominal surgery, dexmedetomidine supplemented analgesia decreases morphine consumption, improves analgesic effects and subjective sleep quality without increasing adverse events.
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Sensorimotor conflict induces both sensory and motor disturbances, but the specific factors playing a role in conflict-induced disturbances are still misunderstood. For example, we still do not know the role played by motor intention (vs. a purely visuo-proprioceptive conflict) or the influence of specific types of incongruent visual feedback. The objective of this study was threefold: 1- to compare the effect of passive and active movement during sensorimotor conflict on sensory disturbances measured with a questionnaire; 2- to compare the effect of three incongruent visual feedback conditions on sensory and motor (mediolateral drift and movement amplitude) disturbances; 3- to test whether conflict-induced sensory and motor disturbances were stable over time. 20 healthy participants realized active or passive cyclic upper limb movements while viewing either congruent or incongruent visual feedback about their movement using a robotized exoskeleton combined with 2D virtual reality interface. ⋯ Second, the three conditions of incongruence in the active condition induced similar sensory (all p>0.45) and motor disturbances (medio-lateral drift: all p>0.59 and amplitude: all p>0.25), suggesting that conflict induced motor disturbances could be related more to the observation of another movement rather than to a detection of conflict between motor intention and sensory feedback. Finally, both sensory and motor disturbances were stable over time (all ICCs between 0.76 and 0.87), demonstrating low variability within participants. Overall, our results suggest that the efference copy is more involved in sensory disturbances than in motor disturbances, suggesting that they might rely on independent processes.
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Review Meta Analysis
Efficacy and safety of direct oral anticoagulants approved for cardiovascular indications: Systematic review and meta-analysis.
Direct oral anticoagulants (DOACs) have emerged as promising alternatives to vitamin K antagonists (VKAs) for patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE). Few meta-analyses have included all DOACs that have received FDA approval for these cardiovascular indications, and their overall comparisons against VKAs have shortcomings in data and methods. We provide an updated overall assessment of the efficacy and safety of those DOACs at dosages currently approved for NVAF or VTE, in comparison with VKAs. ⋯ Patients receiving DOACs for NVAF had predominantly superior efficacy and safety. Patients who were treated with DOACs for acute VTE had non-inferior efficacy, but an overall superior safety profile.
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Auxin response factors (ARF) are important transcription factors which mediate the transcription of auxin responsive genes by binding directly to auxin response elements (AuxREs) found in the promoter regions of these genes. To date, no information has been available about the genome-wide organization of the ARF transcription factor family in physic nut. In this study, 17 ARF genes (JcARFs) are identified in the physic nut genome. ⋯ Of the 17 JcARF genes, eight are predicted to be the potential targets of small RNAs; most of the genes show differential patterns of expression among four tissues (root, stem cortex, leaf, and seed); and qRT-PCR indicates that the expression of all JcARF genes is inhibited or induced in response to exogenous auxin. Expression profile analysis based on RNA-seq data shows that in leaves, 11 of the JcARF genes respond to at least one abiotic stressor (drought and/or salinity) at, as a minimum, at least one time point. Our results provide valuable information for further studies on the roles of JcARF genes in regulating physic nut's growth, development and responses to abiotic stress.
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Pancreatic fistula/PF is the most frequent and feared complication after distal pancreatectomy/DP. However, the safest technique of pancreatic stump closure remains an ongoing debate. Here, we aimed to compare the safety of different pancreatic stump closure techniques for preventing PF during DP. ⋯ After DP, stapler closure, pancreatic anastomosis, or falciform/seromuscular patches lead to lower PFR than suture closure alone. However, the differences are rather small, and further RCTs are needed to test these effects. Selective closure of the main pancreatic duct during stump closure may prevent severe PF.