Minerva medica
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Observational Study
Sublingual sufentanil tablet system for postoperative analgesia after gynecological surgery.
Gynecological procedures are among the most frequent surgical interventions, and effective postoperative analgesia is associated with improved patient comfort. Despite the efficacy of neuraxial analgesia, limitations and potential complications have led to seek new strategies for pain relief. A novel, pre-programmed, non-invasive, hand-held system (Sufentanil Sublingual Tablet System [SSTS]) displayed good results in the orthopedic setting. However, it has never been applied in gynecological procedures. ⋯ SSTS may be an interesting option for postoperative analgesia in gynecologic procedures. The efficacy in the management of dynamic pain is an interesting outcome that needs to be compared with the other standards of pain management, such as neuraxial techniques. Rigorous studies are required to give conclusive evidence, but this is the first report, to our knowledge, of SSTS use in open gynecologic procedures. Our preliminary experience encourages the routine application of SSTS in gynecologic surgery and will help designing future randomized controlled trials on the topic.
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At present, the etiopathogenesis of Alzheimer's disease (AD), the most common form of dementia, remains far to be fully deciphered. In the recent years, also the centrality of amyloid-β peptide in the pathogenesis of the neurodegenerative disease has been questioned and other hypotheses have been advanced. Notably, a common denominator of many of these theoretical models is represented by oxidative stress, which is widely proposed to play a role in the disease initiation and/or progression. ⋯ The peculiar multi-functionality nature of PON1 might be the key for explaining the vast epidemiological data showing a close association between low serum PON1 activity and risk of several diseases, including cardiovascular and neurodegenerative diseases, in particular AD. In this review, we discuss the possible link between PON1 with AD pathogenesis and we hypothesize eventual mechanistic pathways that could account from epidemiological observations. We also highlight the methodological issue limitation in PON1 studies that still impede to give a definitive and certain picture of its effective biological impact on human health including AD.
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The aim of f this study is to investigate the effect of vitamin D supplementation upon the outcome of in-vitro fertilization (IVF) in infertile women with polycystic ovarian syndrome (PCOS) and insulin resistance (IR). ⋯ Our data indicate that vitamin D supplementation can help return serum vitamin D levels in infertile women with PCOS and IR to normal levels leading to an improvement in the quality of embryos and a significantly higher clinical pregnancy rate. Maintaining a normal serum vitamin D level in PCOS women is very important in achieving a successful clinical pregnancy following in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).