Inspiratory Muscle Training Improves Cough Strength in Frail Older Adults

A recent randomized controlled trial has shown that inspiratory muscle training (IMT) significantly enhances cough strength in older adults with frailty, suggesting its potential as a targeted intervention for this vulnerable population.

The study involved 60 frail older adults, with 52 completing the trial. Participants were randomly assigned to either an IMT group, which performed inspiratory muscle exercises alongside general exercise training, or a control group that engaged in general exercise training alone. 

IMT participants used a threshold device set at 30% of their maximum inspiratory pressure, performing 30 breaths twice daily over eight weeks.

The primary outcome, cough peak flow (CPF), demonstrated notable improvement in the IMT group, with an average increase of 28.7 ± 44.4 L/min compared to a decrease of -7.4 ± 26.6 L/min in the control group. The mean difference between groups was 36.3 L/min (95% CI: 16.7–55.9), with a large effect size of 0.99.

These findings indicate that IMT is a practical and effective approach to strengthening respiratory muscles, leading to improved cough function in frail older adults. Enhanced cough strength can play a critical role in reducing the risk of complications such as aspiration and respiratory infections, offering a valuable addition to care strategies for this demographic.
 

Combination Therapy with Tadalafil and Tamsulosin Enhances LUTS Outcomes but Increases Side Effects

A meta-analysis of 12 randomized controlled trials involving 1,531 patients has demonstrated that combination therapy with tadalafil and tamsulosin is more effective than monotherapy for managing lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH), with or without erectile dysfunction (ED). However, this combined approach also leads to higher rates of adverse effects.

The analysis revealed significant improvements in the total International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and quality of life (QoL) for patients receiving combination therapy compared to monotherapy. 

Specifically, the combined treatment enhanced IPSS voiding scores and reduced postvoid residual urine (PVR) more effectively than tamsulosin alone, although PVR outcomes were similar to tadalafil monotherapy.

In terms of erectile function, measured by the International Index of Erectile Function (IIEF), the combined therapy outperformed tamsulosin but did not show additional benefits over tadalafil alone. Importantly, while no serious adverse events were reported, the incidence of minor side effects was higher in the combination therapy group than in the monotherapy groups.

These findings suggest that tadalafil and tamsulosin combination therapy provides superior outcomes for LUTS/BPH management, though its benefits for ED are less clear. Clinicians should weigh these advantages against the increased likelihood of mild adverse effects when considering combination treatment for their patients.
 

Preemptive Ibuprofen and Potassium Fluoride Combination Reduces Tooth Sensitivity After Whitening

A triple-blind, randomized clinical trial has shown that the preemptive use of ibuprofen (IBU) combined with potassium fluoride 2% (KF2) significantly reduces tooth sensitivity immediately after in-office bleaching procedures.

The study involved 15 participants using a crossover and split-mouth design to evaluate the analgesic effects of the combined treatment compared to ibuprofen or potassium fluoride alone and placebo. Participants reported tooth sensitivity levels on a visual analog scale at four intervals: immediately post-bleaching and at 6, 30, and 54 hours.

The combination of 400 mg of ibuprofen and 2% potassium fluoride outperformed the placebo group in reducing immediate tooth sensitivity (P < 0.05). Notably, the risk of experiencing moderate or severe sensitivity was four times higher in the placebo group compared to the combined treatment group (relative risk 4.00, 95% CI: 1.01–15.81, P = 0.025).

These findings suggest that the synergistic use of ibuprofen and potassium fluoride provides superior pain management during bleaching, making it a practical preemptive strategy for patients undergoing tooth whitening procedures. This approach can enhance patient comfort and satisfaction by minimizing post-bleaching sensitivity.
 

Serum Periostin, A Promising Biomarker for Diagnosing and Assessing Allergic Rhinitis Severity

A pilot study has identified serum periostin as a potential biomarker for diagnosing allergic rhinitis (AR) and evaluating disease severity, suggesting its role in assessing airway inflammation.

The study involved 40 AR patients and 22 healthy controls, all over 18 years of age. Participants' serum levels of periostin, total IgE, specific IgE, and remodeling-related factors were measured, alongside assessments of fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (FnNO).

Key findings include:

Serum periostin levels were significantly higher in AR patients compared to controls (p < 0.001).

A positive correlation was found between serum periostin and FeNO (r = 0.398, p = 0.012), FnNO (r = 0.379, p = 0.017), and ocular tearing (r = 0.351, p = 0.026).

Periostin levels were higher in moderate-to-severe AR patients compared to those with mild AR (p = 0.045).

The study found that serum periostin could moderately predict AR diagnosis, with an AUC of 0.773 (p < 0.001).

These results suggest that serum periostin may serve as a reliable biomarker for AR detection and a surrogate marker for evaluating airway inflammation, offering a potential tool for better management of AR patients.

Evaluation of post-operative pain in non-surgical root canal therapy: Comparison of sealer-based obturation with warm vertical compaction

Recent study results indicated that the sealer-based obturation (SBO) technique utilizing calcium silicate sealer (CSS) is correlated with similar post-operative pain levels and analgesic consumption as warm-vertical compaction (WVC) with resin-based sealer (RBS). Therefore, SBO with CSS may be a practical clinical alternative in the context of post-operative pain. The International Endodontic Journal has highlighted the results of this study.

This study included 195 patients who were referred for non-surgical root canal treatment (NSRCT) and fulfilled the essential inclusion criteria. Before the treatment, periapical radiographs and CBCT scans were conducted, and pain was assessed using a numerical rating scale (NRS). After completing the canal instrumentation, participants were randomly assigned to either Group SBO, which received SBO with CSS, or Group WVC, which utilized warm-vertical compaction with RBS. Post-operative pain levels and analgesic use were recorded at one, three, and seven days following the endodontic procedure. The differences in pain scores among the groups were assessed using the Mann-Whitney U and Friedman tests, while a generalized estimating equation was applied to evaluate correlations at different time points within each treatment group.

In the final analysis, 194 participants and 211 teeth were included, producing a response rate of 99.5%. There were no significant differences in post-operative pain or the use of analgesics between the two groups at any time point (p value > .05). On the other hand, pre-operative pain, age, apical diagnosis, and post-operative analgesic intake were significantly linked to post-operative pain (p value < .05).

The above findings indicated that the sealer-based obturation technique utilizing CSS is linked to post-operative pain and analgesic use that are comparable to warm-vertical compaction WVC with RBS. Therefore, SBO with CSS could be a practical alternative for managing pain after surgery.