The comparison between oral arsenic plus imatinib and imatinib alone for the treatment of newly diagnosed chronic myeloid leukemia, Docvidya, Medshorts, Haematology, Hematologist, Blood-related, chronic phase chronic myeloid leukemia (CP-CML), realgar-indigo naturalis formula (RIF), overall survival, imatinib, imatinib combined with arsenic, progression-free survival (PFS), major molecular response (MMR)

The comparison between oral arsenic plus imatinib and imatinib alone for the treatment of newly diagnosed chronic myeloid leukemia

A recent study has shown that the use of imatinib combined with arsenic realgar-indigo naturalis formula (RIF) as a first-line treatment for newly diagnosed chronic phase chronic myeloid leukemia (CP-CML) could potentially lead to a more effective achievement of a deeper molecular response when compared with imatinib as a standalone therapy. This study’s findings were published in the Journal of Cancer Research and Clinical Oncology. 
In this randomized, double-blind, multicentered phase III trial, 191 outpatients with newly diagnosed CP-CML were randomly assigned to receive oral RIF combined with imatinib (n = 96) or placebo combined with imatinib (n = 95). The primary end point of this study was the major molecular response (MMR) at six months. Secondary end points of this study included molecular response 4 (MR4), molecular response 4.5 (MR4.5), overall survival (OS), progression-free survival (PFS), and adverse events.

Baselines demographic data was well balanced between the two groups. The median duration of follow-up was 51 months. There was no significant difference in the rates of MMR between the combination and imatinib arms at 6 months (11.5% vs 12.6%; p = 0.828) or any other point throughout the trial. The 12-month cumulative rates of MR4.5 in the combination and imatinib arms were 20.8% and 10.5% (p = 0.043), respectively. In the core treatment with the two-year analysis, the frequency of MR4.5 was 55.6% in the combination arm compared to 38.6% (p = 0.063) in the imatinib arm. In both, combination arm and imatinib arm, the PFS (93.7% vs 95.8%; p = 0.546) and OS (92.3% vs 94.6%; p = 0.588) were similar at five years. Both groups exhibited similar safety profiles as well.

According to the above study, the combination of imatinib and RIF as a first-line therapy for CP-CML may potentially yield superior outcomes in terms of attaining a more profound molecular response, when compared to imatinib alone.
 

Transurethral surgery for benign prostatic hyperplasia with detrusor underactivity, Docvidya, Medshorts, Urologist, Urology, LUTS due to BPH, Benign prostatic hyperplasia, Detrusor underactivity, Transurethral surgical treatment

Transurethral surgery for benign prostatic hyperplasia with detrusor underactivity

According to a recent study, transurethral surgery can enhance the symptoms experienced by individuals with benign prostatic hyperplasia (BPH) and detrusor underactivity (DU). Additionally, surgical intervention offers benefits that surpass those of pharmacological approaches for BPH patients with DU. The results of this study were documented in the journal Systematic Reviews.
The search for relevant evidence involved three databases (Embase, PubMed, and Web of Science) from their inception to May 1, 2023. Different transurethral surgical procedures include photoselective vaporization of the prostate (PVP), transurethral incision of the prostate (TUIP), and transurethral prostatectomy (TURP). The efficacy of the surgical intervention was assessed according to international prostate symptom score (IPSS), maximal flow rate on uroflowmetry (Qmax), maximal detrusor pressure at maximal flow rate (PdetQmax), quality of life (QoL), postvoid residual (PVR), voided volume, and bladder contractility index (BCI). Mean differences from pooled data were utilized for comparison, while the quality of research studies was evaluated using the Newcastle-Ottawa Scale. Sensitivity analysis and funnel plots were utilized to identify potential biases. 
A total of 1142 patients were included from 10 different studies. For patients with BPH and DU, significant enhancements in IPSS (pooled MD, -14.29; 95% confidence interval, -16.67-11.90; P value < 0.05), Qmax (pooled MD, 4.79; 95% confidence interval, 2.43-7.16; P value < 0.05), QoL (pooled MD, -1.57; 95% confidence interval, -2.37-0.78; P value < 0.05), BCI (pooled MD, 23.59; 95% confidence interval, 8.15-39.04; P value < 0.05), voided volume (pooled MD, 62.19; 95% confidence interval, 17.91-106.48; P value < 0.05) and PdetQmax (pooled MD, 28.62; 95% confidence interval, 6.72-50.52; P value < 0.05) were noted within six months post-surgery. 
Additionally, significant improvements in IPSS (pooled MD, -13.76; 95% confidence interval, -15.17-12.35; P value < 0.05), Qmax (pooled MD, 6.75; 95% confidence interval, 4.35-9.15; P value < 0.05), PVR (pooled MD, -179.78; 95% confidence interval , -185.12-174.44; P value < 0.05), PdetQmax (pooled MD, 27.94; 95% confidence interval, 11.70-44.19; P value < 0.05), and QoL (pooled MD, -2.61; 95% confidence interval, -3.12-2.09; P value < 0.05) were observed after more than one year. When compared to DU patients who did not undergo surgery, those who did showed greater improvements in PdetQmax (pooled MD, -8.00; 95% confidence interval, -14.68-1.32; P value < 0.05) and PVR (pooled MD, 137.00; 95% confidence interval, 6.90-267.10; P value < 0.05). 
Thus, it can be concluded that BPH and DU symptoms can be improved through transurethral surgery. Additionally, surgical intervention offers benefits that are superior to pharmacological methods for BPH patients with DU.
 

Anemia Linked to Increased All-Cause Mortality in Critically Ill Patients Post-CRRT, Docvidya, Medshorts, Renal Anemia, Anemia, Red blood cell transfusions, Erythropoiesis-stimulating agents, Cardiovascular events, Continuous renal replacement therapy

Anemia Linked to Increased All-Cause Mortality in Critically Ill Patients Post-CRRT

Anemia frequently complicates the clinical course of critically ill patients undergoing continuous renal replacement therapy (CRRT). 
A recent retrospective cohort study examined the implications of anemia, characterized by the need for red blood cell (RBC) transfusions or erythropoiesis-stimulating agents (ESAs), on patient outcomes after discharge from the hospital. 
Utilizing data from the Health Insurance Review and Assessment database in South Korea, the study encompassed 10,923 adult patients who received CRRT for at least three days between 2010 and 2019 and were discharged alive.
The findings indicated that patients with anemia tended to be older, predominantly female, and had a higher prevalence of comorbid conditions compared to those without anemia. 
While anemia did not correlate with an increased risk of new-onset cardiovascular events (adjusted hazard ratio [aHR]: 1.05; 95% confidence interval [CI]: 0.85-1.29), it was significantly associated with a heightened risk of all-cause mortality (aHR: 1.41; 95% CI: 1.30-1.53). 
These results suggest that, for critically ill patients with acute kidney injury requiring CRRT, the presence of anemia may substantially elevate the long-term risk of mortality, highlighting the importance of monitoring and managing anemia in this vulnerable population.
 

Assessment of a combined mouthwash for alleviating pain in cases of pericoronitis, Docvidya, Medshorts, Dental, Dental &amp; oral Health, Dentists, Dental Pain, Mouthwashes, Chlorhexidine, Pain, Pericoronitis

Assessment of a combined mouthwash for alleviating pain in cases of pericoronitis

A recent study has shown that the use of both chlorhexidine mouthwash and combined mouthwash resulted in a notable increase in maximum mouth opening. However, there were no notable differences in efficacy observed between the two cohorts. The results of this study were documented in the BMC Oral Health journal. 
In this randomized clinical trial, forty-eight pericoronitis patients (average age of 21.56 yrs) were randomized into two groups. The control group was given a 0.12% chlorhexidine mouthwash, while the case group was provided with a mouthwash that contained Chlorhexidine, Nanosilver, Benzydamine, Amoxicillin, and Metronidazole. Visual Analog Scale (VAS) scores were monitored for seven days, and Maximum mouth opening (MMO) was measured at the beginning and after seven days. The data analysis was performed using SPSS v20.
The groups did not show any substantial variation in pain reduction. However, both groups experienced a decrease in pain and an improvement in Maximum mouth opening (MMO) following the treatment. There was a balanced gender distribution in both groups.
The above study demonstrated that both chlorhexidine mouthwash and combined mouthwash usage led to a marked improvement in maximum mouth opening. However, there were no substantial variations in efficacy between both groups.
 

Allergic Rhinitis Increases Risk for Moderate-to-Severe Pediatric Obstructive Sleep Apnea, Docvidya, Medshorts, Allergic rhinitis, Consultant Physician, General Practitioner, General Practice, Obstructive sleep apnea, Apnea-hypopnea index, Lowest oxygen saturation, Hypoxemia, Polysomnography

Allergic Rhinitis Increases Risk for Moderate-to-Severe Pediatric Obstructive Sleep Apnea

A recent study has highlighted allergic rhinitis (AR) as a significant predictor of moderate-to-severe obstructive sleep apnea (OSA) in children.

Conducted at the Children's Hospital of Chongqing Medical University, the research analyzed 263 pediatric patients diagnosed with OSA in 2020, assessing factors contributing to disease severity.

Polysomnography was performed to determine each patient’s apnea-hypopnea index (AHI) and lowest oxygen saturation (LSaO₂), essential markers of OSA severity. The study found that nearly half (48.7%) of the patients had moderate-to-severe OSA, with 60.8% experiencing moderate-to-severe hypoxemia.

After adjusting for various factors, AR (adjusted odds ratio [aOR] = 1.75, 95% confidence interval [CI]: 1.03-2.96) and male gender (aOR = 1.77, 95% CI: 1.03-3.06) were identified as independent risk factors for more severe OSA. Notably, AR also emerged as the sole predictor of hypoxemia, further emphasizing its role in worsening sleep-disordered breathing.

These findings underscore the necessity of early detection and management of AR in children to reduce the risk of severe OSA and its complications. Individualized therapeutic approaches for pediatric OSA patients, particularly those with AR, could improve outcomes and mitigate progression to more severe disease stages.

Analgesic onset of FA-acetaminophen in a postoperative dental impaction pain model, Docvidya, Medshorts, Dental, fast-acting acetaminophen (FA-acetaminophen), commercial acetaminophen caplets (ES-acetaminophen), commercial ibuprofen liquid-filled gelatin capsules (LG-Ibuprofen), impacted third molars, perceptible pain relief (TCPR), meaningful pain relief (TMPR).

Analgesic onset of FA-acetaminophen in a postoperative dental impaction pain model

A recent study has shown that fast-acting acetaminophen (FA-acetaminophen) had a quicker onset of action than both commercial acetaminophen caplets (ES-acetaminophen) and commercial ibuprofen liquid-filled gelatin capsules (LG-Ibuprofen). This study findings were published in the journal, Current Medical Research and Opinion.

Two single-center, randomized, inpatient, placebo-controlled, double-blind design clinical trials were carried out utilizing the postoperative dental impaction pain model. Study 1 included 240 subjects, whereas study 2 had 420 subjects. The individuals involved in this study were between the ages of 17 and 50 and were suffering from moderate to severe pain after undergoing the surgical extraction of a minimum of three impacted third molars. The two studies evaluated four different treatment groups: 1,000 mg of FA-acetaminophen, 400 mg of LG-ibuprofen, 1,000 mg of ES-acetaminophen, and a placebo. The double-stopwatch method was used to determine the times to confirm perceptible pain relief (TCPR) and meaningful pain relief (TMPR). Pain intensity and relief were assessed using a 0-10 numerical rating scale for a duration of 6 hours after administering the drug.

The efficacy results demonstrated that all active treatments were statistically superior to the placebo. Within study 1, TCPR was significantly shorter for FA-acetaminophen in comparison to ES-acetaminophen and LG-ibuprofen. Additionally, FA-acetaminophen 1,000 mg showed a significantly shorter TMPR compared to LG-ibuprofen. In both studies 1 and 2, at the 15-minute mark post-administration of the study drug, PID and PAR scores were higher for FA-acetaminophen than LG-ibuprofen.

It can be concluded that FA-acetaminophen demonstrated a faster onset of action in comparison to both ES-acetaminophen and LG-Ibuprofen.

Insights from the RHINESSA Study suggest Chronic Cough to be Heritable Across Generations, Docvidya, Medshorts, Chronic Cough, Productive cough, Non-productive cough, Asthma, Body Mass Index, Rhinitis

Insights from the RHINESSA Study suggest Chronic Cough to be Heritable Across Generations

This study investigated the heritability of chronic cough, examining whether individuals with chronic cough are more likely to have offspring who also develop cough, and whether this association varies by cough type (productive vs. nonproductive).

The RHINESSA Generation Study included 7,155 parents aged 30-54 who completed detailed questionnaires in 2000 and 2010, and 8,176 offspring aged ≥20 who completed similar questionnaires between 2012-2019. Chronic cough was classified as either productive or nonproductive. Mixed-effects logistic regression analyses were conducted to assess the associations between parental and offspring cough, adjusting for multiple factors including offspring age, sex, body mass index, smoking history, asthma, rhinitis, gastroesophageal reflux, and parental smoking.

Results indicated that offspring of parents with nonproductive cough had a higher prevalence of nonproductive cough (11%) compared to those with parents without nonproductive cough (7%), with an adjusted odds ratio (aOR) of 1.59 (95% CI: 1.20-2.10). Similarly, offspring of parents with productive cough had a higher prevalence of productive cough (14%) compared to those with non-productive cough parents (11%), with an aOR of 1.34 (95% CI: 1.07-1.67). No significant associations were found between mismatched cough types.

These findings suggest that chronic cough, independent of asthma, may be a distinct heritable trait with type-specific transmission patterns.

The effect of various desensitizers on pulpal blood flow after full crown preparation using laser Doppler flowmetry, Docvidya, Medshorts, Dental, Dental &amp; Oral Health, Dentist, Dentinal Hypersensitivity, Dentin hypersensitivity, Desensitizer, Pulpal blood flow, Laser Doppler flowmetry

The effect of various desensitizers on pulpal blood flow after full crown preparation using laser Doppler flowmetry

In a recent study, similar levels of effectiveness were observed in treating dentine hypersensitivity and pulpal blood flow with Bifluoride 12, Teethmate, and Copal Varnish. This study’s findings were published in the journal Odontology.
18 patients with a total of 42 teeth suffering from dentine hypersensitivity after full crown preparations were randomly divided to receive treatment with Bifluoride 12, Teethmate, or Copal Varnish. The severity of dentine hypersensitivity was assessed using a Schiff air index (SAI) and visual analog scale (VAS). The assessment of pulpal blood flow involved the use of laser Doppler flowmetry (LDF), with the findings recorded in perfusion units (PU). Evaluations were conducted at the initial stage, after five minutes, after seven days, and after one month subsequent to the administration of desensitizing agents. Statistical analysis was carried out using Wilcoxon and two-way ANOVA tests (p value < 0.05).

The tested desensitizers did not show any significant difference in terms of VAS and PU values. VAS values significantly decreased at seven days and one month after the desensitizers were applied, compared to the baseline in all groups. Only the Copal Varnish group exhibited a notable difference in PU values at the five-minute and seven-day intervals post-desensitizer application (p value < 0.05). A statistically significant difference was found between different time points in relation to SAI scores in all groups (p value < 0.05).

Thus, it can be concluded that Bifluoride 12, Teethmate, and Copal Varnish demonstrated similar effectiveness in managing dentine hypersensitivity and pulpal blood flow. To fully evaluate their impact on pulpal status, it is important to conduct long-term clinical trials with larger sample sizes and histological studies.