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Statistical analysis
The sample size was calculated using MedCalc Software version 14 (MedCalc Software bvba, Ostend, Belgium) to find the null hypothesis with the area under the receiver operating characteristic (AUROC) curve of 0.5 and AUROC of 0.80. We calculated a minimum of 45 patients for a study power of 80% and an error of 0.05 bec...
PMC10171442
Discussion
paresthesia, BP block, peripheral block
VASODILATATION, VASODILATION, PARESTHESIA, BLIND
Over the years, several techniques have been used to achieve successful and safe peripheral block application. The paresthesia technique is a blind technique based on direct contact with nerve fibers. This technique is based on the perception of stimulation sensation and is a subjective technique that can be confusing ...
PMC10171442
Conclusion
PI is a useful and objective metric in the prediction of the infraclavicular PB block success. It was found that block success may be predicted by degrees of increase of 3.8 or higher for sensory block and 3.9 or higher for motor block.Conflicts of interest: Authors declare no conflicts of interest.Funding: Authors rec...
PMC10171442
References
PMC10171442
Background
hip arthroplasty, postoperative pain, THA
This investigation aimed to evaluate the impact of continuous pericapsular nerve group (PENG) block and continuous fascia iliac compartment block (FICB) on postoperative pain following total hip arthroplasty (THA).
PMC10334586
Methods
femoral neck fractures, fifty-seven, nausea and vomiting, infection, hematoma, catheter detachment
ADVERSE EVENTS, INFECTION, HEMATOMA
This prospective, randomized, and controlled trial recruited a cohort of fifty-seven patients with unilateral femoral neck fractures from Xi’an Aerospace General Hospital in northwest China between July 2020 and November 2021. These patients were randomly assigned to two groups: the continuous PENG block group (PENG gr...
PMC10334586
Results
pain
In the PENG group, the resting NRS pain scores exhibited lower values at T1, T4, and T5 than those at T0. Furthermore, exercise NRS pain scores at T1-T5 were lower in the PENG group than in the FICB group. Similarly, during the same postoperative period, the PENG group demonstrated enhanced quadriceps strength on the a...
PMC10334586
Conclusion
THA
Continuous PENG block exhibited superior analgesic efficacy after THA compared to continuous FICB, promoting recovery of quadriceps strength on the affected side and facilitating early postoperative ambulation.
PMC10334586
Trial Registration
This clinical trial was registered in the China Clinical Trials Center (
PMC10334586
Keywords
PMC10334586
Introduction
postoperative pain, postoperative quadriceps muscle strength, infection, Total hip arthroplasty, hematoma, catheter detachment, THA, nausea, vomiting
ADVERSE EVENTS, INFECTION, THROMBOEMBOLIC EVENT, HEMATOMA
The hip joint, a crucial ball-and-socket joint essential for lower limb mobility [Total hip arthroplasty (THA) is a commonly employed procedure for FNF treatment. However, severe postoperative pain following THA delays motor function recovery, increases the risk of hospitalization and thromboembolic events, and adverse...
PMC10334586
Materials and methods
PMC10334586
Study design
This prospective, randomized, and controlled trial received approval from the Hospital Medical Ethics Committee (Lot No. XHTZYY-2020-LL-02) on 08/07/2020 and was registered with the China Clinical Trials Center ( Flowchart of the entry group
PMC10334586
Grouping and interventions
anterior inferior iliac spine
Treatment allocation was concealed using consecutively numbered, sealed, opaque envelopes held by an anesthesia nurse who was not involved in the study. The envelopes were handed to the anesthesiologist performing the nerve block on the day of surgery. Both groups of patients fasted for eight hours and refrained from c...
PMC10334586
Anesthesia application
skin pain
BLOOD, LOCAL INFILTRATION
Thirty minutes after completion of the block, the patient was repositioned in the healthy side-lying position, with the affected side facing upward, and spinal anesthesia was performed at the L3-4 interspace. Upon penetration of the spinal anesthesia puncture needle into the arachnoid and subsequent cerebrospinal fluid...
PMC10334586
Postoperative analgesia protocol and rescue analgesic
NRS
Following the surgical procedure, patients were admitted to the post-anesthesia care unit (PACU) and subsequently transferred to the ward upon stabilization of vital signs. All patients received the same postoperative multimodal analgesia regimen, which included intravenous administration of ketorolac tromethamine 30 m...
PMC10334586
Measurements
NRS, pain
The numerical rating scale (NRS) at rest and during exercise were recorded as the primary outcome at multiple time points: before block (T0), 30 min post-blockade (T1), and 6 h (T2), 12 h (T3), 24 h (T4), and 48 h (T5) postoperatively. Exercise pain was evaluated based on the NRS score corresponding to passive straight...
PMC10334586
Statistical analysis
NRS
The Kolmogorov-Smirnov normality test was conducted for continuous variables. Normally distributed variables were expressed as mean ± standard deviation (SD), and independent samples t-test was used for between-group comparisons. Non-normally distributed variables were expressed as median (interquartile range, IQR) [M ...
PMC10334586
Results
PMC10334586
General information
intraoperative bleeding, SD
INTRAOPERATIVE BLEEDING
A total of 60 patients were initially recruited for the study, with one patient excluded from the PENG group due to the operation duration exceeding 3 h. Ultimately, the statistical analysis included 29 cases in the PENG group. Similarly, one patient was excluded from the FICB group due to lumbar puncture difficulty, a...
PMC10334586
Comparison of postoperative motor ability and postoperative analgesia
SD
When comparing quadriceps strength on the affected side during the same postoperative period, the PENG group exhibited higher strength than the FICB group. Furthermore, the quadriceps strength on the affected side in the FICB group was lower than that of the healthy side in the same group at 24 and 48 h postoperatively...
PMC10334586
Comparison of adverse reactions
Hematoma, nausea, infection, vomiting
HEMATOMA, INFECTION
No nausea and vomiting occurred in the PENG group, but 3 cases occurred in the FICB group, and the difference was not statistically significant (P > 0.05). Hematoma, or infection at the puncture site, was observed between the two groups. Additionally, there were no instances of catheter displacement after surgery.
PMC10334586
Discussion
femoral neck fractures, femoral nerve block, nausea and vomiting, postoperative exercise pain, pain, PENG block, THA
ADVERSE REACTIONS
In this study, a total of 57 patients with femoral neck fractures were randomly assigned to receive either continuous pericapsular nerve group (PENG) block (PENG group, n = 29) or continuous fascia iliaca compartment block (FICB group, n = 28). The results showed that both groups improved exercise NRS pain scores durin...
PMC10334586
Acknowledgements
Not applicable.
PMC10334586
Author contributions
Lei Duan, Conceptualization, Formal analysis, Investigation, Methodology, Validation, Visualization, Writing-original draft, Writing-review & editing. Liang Zhang, Conceptualization, Formal analysis, Investigation, Methodology, Validation, Visualization, Writing - original draft, Writing - review & editing. Chuang-Guo ...
PMC10334586
Funding
This study was funded by the 2021 Xi’an Health Research Talent Project (No. 2021yb57) and the 2020 Medical Research Project of Xi’an Aerospace General Hospital (No. 2020KY001).
PMC10334586
Data availability
The datasets used in the current study are available from the corresponding author upon reasonable request.
PMC10334586
Declarations
PMC10334586
Competing interests
The authors declare no competing interests.
PMC10334586
Ethics approval and consent to participate
This work followed the Consolidated Standards of Reporting Trials (CONSORT) statement and the Declaration of Helsinki. This clinical trial was registered in the China Clinical Trials Center (
PMC10334586
Consent for publication
Not applicable.
PMC10334586
Abbreviations
inferior iliac spineIliopubic
Pericapsular nerve groupFascia iliac compartment blockTotal hip arthroplastyNumerical rating scalePatient-controlled neural analgesiaFemoral neck fracturesNon-invasive arterial blood pressureHeart ratePulse oximetryElectrocardiogramConsolidated Standards of Reporting Trials90% minimum effective volumeAnterior inferior ...
PMC10334586
References
PMC10334586
Background
Gastrointestinal (GI) symptoms, RRMS
RELAPSING-REMITTING MULTIPLE SCLEROSIS
Gastrointestinal (GI) symptoms affect more than 80% of individuals with relapsing-remitting multiple sclerosis (RRMS). Ginger is widely known for its GI relieving properties. Therefore, we investigated the effect of ginger supplementation on common GI symptoms in RRMS patients.
PMC10605938
Methods
bloating, nausea, flatulence, diarrhea, abdominal pain, heartburn, constipation, dysphagia, anorexia
ANOREXIA
This study was a 12-week double-blind parallel randomized controlled trial with a 3-week run-in period. The intervention (n = 26) and control (n = 26) groups received 500 mg ginger and placebo (as corn) supplements 3 times a day along with main meals, respectively. At the beginning and end of the trial, the frequency a...
PMC10605938
Results
In comparison with placebo, ginger supplementation resulted in significant or near-significant reductions in the frequency (-23.63 ± 5.36 vs. 14.81 ± 2.78,
PMC10605938
Conclusion
bloating, abdominal pain, constipation, nausea,, RRMS
Ginger consumption can improve constipation, nausea, bloating, and abdominal pain in patients with RRMS.
PMC10605938
Trial Registration
This trial was prospectively registered at the Iranian Registry of Clinical Trials (
PMC10605938
Keywords
PMC10605938
Background
MULTIPLE SCLEROSIS (MS)
Multiple sclerosis (MS) is a chronic neurodegenerative disease of autoimmune origin [Ginger (Considering the high prevalence of GI problems in MS patients and the positive effects of ginger on the digestive system [
PMC10605938
Materials and methods
PMC10605938
Trial design
This study was a 12-week double-blind parallel randomized placebo-controlled trial with a 3-week run-in period. It was conducted in agreement with the Declaration of Helsinki and its later amendments. Eligible patients were recruited from Fars MS Association and Imam Reza (A.S) Clinic located in Shiraz, Iran. Before th...
PMC10605938
Participants
Based on the sample size calculation described in detail in our published study protocol [
PMC10605938
Randomization and blinding
RRMS
Eligible RRMS patients were assigned to ginger and placebo groups using stratified permuted block randomization (allocation ratio = 1:1, block size = 4). The stratification was performed according to gender. The following website was used for the generation of random allocation sequence:
PMC10605938
Run-in period
RRMS
Before random allocation, eligible participants underwent a three-week run-in period. During this time, RRMS patients were requested to avoid consuming ginger and its products and to maintain their usual physical activity and dietary intake.
PMC10605938
Intervention
The treatment and control groups received 500 mg ginger and placebo (corn) tablets thrice a day with main meals for 12 weeks, respectively. Each 500 mg ginger tablet was standardized to contain 25 mg gingerols. Ginger and placebo supplements were provided by Dineh Iran Industries Complex, Tehran, Iran. During the trial...
PMC10605938
GI symptoms
bloating, nausea, flatulence, diarrhea, abdominal pain, heartburn, constipation, dysphagia, anorexia
ANOREXIA
At the beginning and end of this trial, the frequency and severity of constipation, dysphagia, abdominal pain, diarrhea, bloating, belching, flatulence, heartburn, anorexia, and nausea were assessed using the visual analogue scale (VAS) ranging from 0 mm (none) to 100 mm (worst possible). This assessment tool has previ...
PMC10605938
Physical activity and dietary intake
Physical activity and dietary intake can affect GI symptoms [
PMC10605938
Statistical analysis
Data analysis was performed according to the intention-to-treat (ITT) principle using IBM SPSS Statistics software (version 26, IBM Corporation, Armonk, New York, United States). The expectation-maximization algorithm was run to impute missing values in ITT analysis [
PMC10605938
Discussion
dysphagia, bloating, flatulence, diarrhea, abdominal pain, heartburn, dyspepsia, anorexia, constipation, nausea and constipation, nausea,, RRMS, Constipation
DYSPHAGIA, ANOREXIA
The findings of this study indicated that 1500 mg/d ginger supplementation for 12 weeks statistically significantly reduced the frequency and severity of nausea and constipation as well as the severity of bloating. In addition, supplementation with ginger caused statistically near-significant reductions in the frequenc...
PMC10605938
Conclusion
bloating, abdominal pain, constipation, nausea,, RRMS
In conclusion, ginger consumption seems to alleviate GI symptoms in patients suffering from RRMS. Particularly, ginger supplementation can improve constipation, nausea, bloating, and abdominal pain in patients with RRMS. Nevertheless, further clinical trials and mechanistic studies are necessary to confirm these findin...
PMC10605938
Acknowledgements
Not applicable.
PMC10605938
Authors’ contributions
RA, MP
SF and RA conceptualized and designed the study. SF and MP administered supplements and collected data. SF and ZH analyzed data. SF wrote the manuscript, and RA critically revised it. All authors read and approved the final manuscript.
PMC10605938
Funding
This article was extracted from the PhD thesis of Sahar Foshati and was funded by Isfahan University of Medical Sciences under grant number 3400357. The funding source had no role in the conception and design of the trial, data collection, statistical analysis, interpretation of results, and manuscript preparation.
PMC10605938
Data Availability
The data supporting the results of this trial are available from the corresponding author, upon reasonable request.
PMC10605938
Declarations
PMC10605938
Ethics approval and consent to participate
This trial was done in agreement with the Declaration of Helsinki and its later amendments. It was approved by the Ethics Committee at the Isfahan University of Medical Sciences under the code IR.MUI.RESEARCH.REC.1400.248. Before the enrollment, informed consent was obtained from the participants.
PMC10605938
Consent for publication
Not applicable.
PMC10605938
Competing interests
The authors declare no competing interests.
PMC10605938
References
PMC10605938
Key Contribution
Aflatoxin BNaturally occurring concentrations of AFB
PMC9964898
1. Introduction
Aflatoxins (AF), produced by The US Food and Drug Administration has established 20 μg/kg as the action level for AFBThe detrimental effects of AFBTo the best of our knowledge, only one recent study examined the effects of a close to naturally occurring concentration of AFB
PMC9964898
2. Results
The basal diet provided 15.9% of crude protein (CP) and 1.61 Mcal/kg of DM (Ruminal pH, NHThe dose of AFBFlows of total N, NHAflatoxin B
PMC9964898
3. Discussion
Previous studies have investigated the effects of AFBPrevious in vitro studies have reported lower concentrations of VFA and NHThe lack of treatment effects on fermentation probably reflects the lack of AFBAflatoxin BPrevious studies examined the recovery of AFBIn a study where AFB
PMC9964898
4. Conclusions
Aflatoxin B
PMC9964898
5. Materials and Methods
The dairy cows used in this study for ruminal content collection were cared for in accordance with guidelines approved by the University of Florida Institutional Animal Care and Use Committee protocol number 202009849.
PMC9964898
5.1. Experimental Design, Treatments, and Diet
A. H. Thomas
Eight dual-flow continuous culture fermenters were used in a replicated 4 × 4 Latin square design. Each fermenter vessel was treated as an experimental unit. Four fermentation periods of 10 d each, consisting of 7 d of adaptation and 3 d of sampling were carried out. Fermenters were randomly assigned to 1 of 4 AFBThe b...
PMC9964898
5.2. Dual-Flow Continuous Culture System Operation and Experimental Period
A dual-flow continuous culture system [Two ruminally cannulated lactating Holstein cows were used as ruminal content donors. Donor cows were fed a total mixed ration containing (DM basis) corn silage (40%), alfalfa hay (3%), ground corn (27.3%), soybean meal 44% (15.5%), citrus pulp (9.2%), and mineral and vitamin prem...
PMC9964898
5.3. Fermentation Profile
Ruminal pH was measured in each fermenter vessel using a portable pH meter (Thermo Scientific Orion Star A121, Thermo Fisher Scientific Inc., Waltham, MA, USA) at 0, 1, 2, 4, 6, and 8 h post-morning feeding during d 8 and 9 of each period. Aliquots of approximately 15 mL of ruminal content from each fermenter were filt...
PMC9964898
5.4. Nutrient Digestibility
A. H. Thomas
ASH
Diet samples were ground through a 1 mm screen in a Wiley mill (A. H. Thomas Co.) and dried in an oven overnight at 105 °C for DM estimation. Samples were ashed at 550 °C for 5 h [For the estimation of ruminal nutrient digestibility, digesta samples collected on d 8, 9, and 10 were freeze-dried for DM determination and...
PMC9964898
5.5. Microbial Protein Synthesis and Ruminal N Metabolism
At the end of each experimental period, microbial pellets from each fermenter vessel were harvested [We used The percent excess of Flows of NHMicrobial efficiency was determined as follows [Efficiency of N used was determined as follows [
PMC9964898
5.6. Aflatoxin B
Ruminal contents (5 mL) from each fermenter were collected at 0, 1, 2, 4, 6, and 8 h after the morning feeding on d 8 and 9. Samples were transferred to screw-capped tubes and frozen at −20 °C until analyzed. We used an ELISA-based kit (AgraQuant
PMC9964898
5.7. Statistical Analysis
Data were analyzed using the GLIMMIX procedure of SAS (version 9.4; SAS Institute, Cary, NC, USA) as a replicated 4 × 4 Latin square design. Data were checked for normality using the UNIVARIATE procedure of SAS (version 9.4; SAS Institute) before analysis. Variables that were measured repeatedly over time (pH, lactate,...
PMC9964898
Supplementary Materials
The following supporting information can be downloaded at: Click here for additional data file.
PMC9964898
Author Contributions
Conceptualization, F.X.A., Y.J., A.T.A. and D.V.; methodology, F.X.A., Y.J., A.P.F. and D.V.; formal analysis, F.X.A. and D.V.; investigation, F.X.A., K.A., M.R.P., B.C.A., S.L.B., J.R.V., L.T., R.R.L. and A.P.-C.; resources, D.V. and A.P.F.; data curation, F.X.A., J.A.A.-C. and D.V.; writing—original draft preparation...
PMC9964898
Institutional Review Board Statement
The animal study protocol was approved by the Institutional Animal Care and Use Committee of UNIVERSITY OF FLORIDA (protocol code 202009849; approval date: 10/06/2020).
PMC9964898
Informed Consent Statement
Not applicable.
PMC9964898
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
PMC9964898
Conflicts of Interest
The authors declare no conflict of interest.
PMC9964898
Background
fracture, pain
Preoperative analgesia of hip fracture in elderly patients is important, but it is also lacking. In particular, nerve block was not provided in time. In order to provide more effective analgesia, we designed a multimodal pain management mode based on instant messaging software.
PMC10061705
Methods
fascia iliaca compartment block, fracture, closed-loop pain, pain
MAY
From May to September 2022, a total of 100 patients with unilateral hip fracture aged over 65 were randomly divided into the test group and the control group. Finally, 44 patients in each group completed the result analysis. A new pain management mode was used in the test group. This mode focuses on the full informatio...
PMC10061705
Results
The time for patients in the test group to complete FICB for the first time was 3.0 [1.925–3.475] h, which was less than the time for patients in the control group (4.0 [3.300–5.275] h). The difference was statistically significant (
PMC10061705
Conclusions
pain
Using instant messaging software, the new model of pain management can enable patients to receive FICB as soon as possible and improve the timeliness and effectiveness of analgesia.
PMC10061705
Trial registration
Chinese Clinical Registry Center, ChiCTR2200059013, 23/04/2022.
PMC10061705
Keywords
PMC10061705
Introduction
Pain, fracture, pain, fractures, trauma
Hip fracture is a common fracture in elderly patients and is the main cause of serious morbidity in elderly individuals aged 65 years and above [Pain management is particularly challenging in elderly patients in acute trauma settings [At present, several studies have shown that the multidisciplinary cooperation analges...
PMC10061705
Methods
PMC10061705
Study design and ethics
This study was designed as a prospective parallel-group randomized controlled trial and conducted at Shengjing Hospital. The investigation was approved by the Institutional Review Board of Shengjing Hospital, China Medical University (approval number 2021PS511K, dated 12/05/2021). The trial was registered with the Chin...
PMC10061705
Inclusion and exclusion criteria
delirium, bleeding, fracture, allergy, opioid addiction, fractures, trauma
BLEEDING, COAGULATION DISORDERS, GASTROINTESTINAL ULCERS, ALLERGY, SITE INFECTION
Inclusion criteria: patients aged ≥ 65 years with unilateral hip fracture who were admitted to our emergency department and were willing to undergo surgical repair.Exclusion criteria: multiple trauma or multiple fractures, coagulation disorders, gastrointestinal ulcers or bleeding, puncture site infections, history of ...
PMC10061705
Randomization and blinding
In this parallel double-blind trial, the computer-generated random allocation sequence was created by an independent investigator using SPSS Statistics (version 24.0, IBM Corp., Armonk, NY, USA) with a 1:1 allocation and random block size. After providing written informed consent, the eligible patients were entered int...
PMC10061705
Interventions
PMC10061705
Test group
Pain, allergy, pain, NRS, trauma
ALLERGY, DISEASES
The core aim of the new pain relief management mode is to establish a pain management group composed of medical personnel from the emergency department, orthopaedics department and anaesthesiology department. Members of the working group have received unified training on the new pain relief mode.The communication withi...
PMC10061705
Control group
fracture, Pain
In this study, each patient's analgesia was directed by the doctor in his or her department, and other departments were invited to consult if necessary.1. Admission evaluation: The emergency medical staff carried out the first comprehensive evaluation after the patient was admitted to the hospital, and the contents wer...
PMC10061705
Outcome measurements
Confusion, postoperative delirium, NRS, pain
1. Time from the emergency room visit to the completion of FICB.2. Number of FICB completed by emergency physicians.3. The maximum NRS, the duration of the maximum NRS, and the duration of NRS > 3 were recorded.4. Analgesic satisfaction score. Patients were given a satisfaction score for preoperative analgesia before ...
PMC10061705
Statistical analysis
PMC10061705
Sample size calculations
The main aim of this study was to compare the first FICB times. Based on the results of the pretest, we assumed that the first FICB timepoint for the test group was 3.0 h and that for the control group was 4.0 h, both with a standard deviation of 1.5. To obtain a statistical power of 90% (β = 0.1) with a two-sided conf...
PMC10061705
Statistical methods
SPSS 24 software was used for statistical analysis. The distribution of continuous variables was tested for normality using Shapiro‒Wilk tests. Normally distributed data were expressed as the mean ± standard deviation (SD), while nonnormally distributed data were expressed as the median (interquartile range [IQR]). Cou...
PMC10061705
Discussion
delirium, fracture, pain, attention disorders, fractures, mental disorder, NRS, nerve block
POSTOPERATIVE COMPLICATION
The results of this study showed that compared with the control group, the patients in the test group received FICB earlier, and their satisfaction with analgesia was improved. The maximum NRS of patients in the test group was lower, and the duration of the maximum NRS and duration of NRS > 3 was shorter.It has been wi...
PMC10061705
Limitations
1. There was no difference in the results of POD in this study. A large sample size will be used in future studies to determine the effect of preoperative analgesia on POD.2. In addition to POD, this study did not analyze the impact of prognostic indicators of patients under the new model. We look forward to finding t...
PMC10061705
Conclusions
hip fracture, pain
For elderly patients with hip fracture, the new pain management mode, supported by instant messaging software, given full play to multidisciplinary cooperation and information exchange to complete FICB as soon as possible for efficient and effective analgesic treatment of patients.
PMC10061705