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Publisher’s note
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PMC10310936
Supplementary material
The Supplementary material for this article can be found online at: Click here for additional data file.Click here for additional data file.Click here for additional data file.
PMC10310936
References
PMC10310936
Abbreviations
Background music.
PMC10310936
Introduction
OPEN-ANGLE GLAUCOMA, INTRAOCULAR PRESSURE
To compare sutureless deep sclerectomy to conventional deep sclerectomy regarding their lowering effect on intraocular pressure (IOP) in cases with open-angle glaucoma.
PMC10049952
Methods
glaucoma, open-angle glaucoma, OAG
OPEN-ANGLE GLAUCOMA, GLAUCOMA
This is a prospective interventional randomized comparative study that included 60 eyes of 50 patients with open-angle glaucoma (OAG) who were indicated for surgical intervention. Patients were recruited from the glaucoma subspecialty clinic of the Cairo University teaching hospital and were divided into two groups: gr...
PMC10049952
Results
COMPLICATIONS
Both surgeries showed significant reduction of IOP all through the study period: in group A, mean reduction was 71.37%, 53.35%, 50.3%, and 44.33% at 1st day, 1 month, 3 months, and 6 months respectively, and in group B, mean reduction was 57.62%, 40.63%, 37.41%, and 31.68% at 1st day, 1 month, 3 months, and 6 months, r...
PMC10049952
Conclusion
POAG
Sutureless deep sclerectomy seems to be a safe and effective modification, with significant IOP reduction in POAG.
PMC10049952
Keywords
Open access funding provided by The Science, Technology & Innovation Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank (EKB).
PMC10049952
Introduction
postoperative hypotony, open-angle glaucoma, OAG, glaucoma, trauma
OPEN-ANGLE GLAUCOMA, COMPLICATIONS, GLAUCOMA, FOREIGN BODY REACTION, INTRAOCULAR PRESSURE
Deep sclerectomy (DS) is a non-penetrating glaucoma surgery that has emerged as a competitor to the standard trabeculectomy which is safer with comparable results regarding intraocular pressure (IOP)-lowering effect in cases with open-angle glaucoma (OAG). DS entails non-penetration of the anterior chamber through leav...
PMC10049952
Methodology
open-angle glaucoma, choroidals, conjunctival leak, dry cellulose, glaucoma, OAG, Glaucoma, fornix-based
NEOVASCULAR GLAUCOMA, SCHEIE, INFLAMMATION, OPEN-ANGLE GLAUCOMA, CORNEA, ANGLE CLOSURE GLAUCOMA, LENS, GLAUCOMA, CONJUNCTIVA, GLAUCOMA
This is a prospective interventional randomized comparative study that compared sutureless versus conventional deep sclerectomy as a primary surgical management for open-angle glaucoma (OAG). The study included 60 eyes of 50 patients with OAG who were indicated for surgical intervention. The study patients were recruit...
PMC10049952
Statistical analysis
Data were coded and entered using the statistical package for the Social Sciences SPSS (IBM, Armonk, NY) version 24. Data was summarized using mean, standard deviation, median, minimum, and maximum in quantitative data and using frequency (count) and relative frequency (percentage) for categorical data. Comparisons bet...
PMC10049952
Author contribution
• Mohamed Sabry Kotb: design of the work, surgical intervention for the patients, analysis and interpretation of the data, review and revision of the manuscript.• Shahenda A El Gharbawy: design of the work, collection, analysis and interpretation of the data, critical review and revision of the manuscript• Ahmed Mostaf...
PMC10049952
Funding
Open access funding provided by The Science, Technology & Innovation Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank (EKB).
PMC10049952
Data availability
All the data used and/or analyzed during the current study are available and can be presented by the corresponding author upon a reasonable request.
PMC10049952
Declarations
PMC10049952
Statement of ethics
All patients signed an informed written consent to participate in the study and to approve sharing of the study data after thorough explanation of the surgical technique and its expected drawbacks. The study was performed according to the tenets of the Declaration of Helsinki. The study protocol was revised and approve...
PMC10049952
Competing interests
The authors declare no competing interests.
PMC10049952
References
PMC10049952
Background
lung cancer, CPSP, pain
LUNG CANCER, INFILTRATION
Academic Editor: Massimiliano Valeriani Thoracoscopic lung cancer surgery is accompanied by severe pain. Both continuous paravertebral block (CPVB) and continuous wound infiltration (CWI) are widely used for perioperative analgesia in thoracoscopic surgery. However, the effects of these different methods on chronic pos...
PMC10653976
Results
pain
The incidence of chronic postsurgical pain in the CWI group was significantly higher than that in the CPVB group at 3, 6, and 9 months after surgery (all
PMC10653976
Conclusion
paravertebral block, pain
CHRONIC PAIN
Continuous ultrasound-guided paravertebral block reduced the intensity of acute pain within 7 days postoperatively and reduced the incidence of chronic pain at 3, 6, and 9 months after surgery, but there was no significant advantage in long-term quality of life. This trial is registered with
PMC10653976
1. Introduction
lung cancer, Lung cancer, CPSP, pain
MALIGNANT TUMOR, LUNG CANCER, INFILTRATION, LUNG CANCER
Lung cancer is the most common malignant tumor in the world, and surgery has been the main treatment option until now [Multimodal analgesia strategies are recommended for the management of pain [Both analgesic techniques have advantages, but the comparative impact of these techniques on CPSP functional recovery and qua...
PMC10653976
2. Methods
PMC10653976
2.1. The Study Design and Participants
This prospective randomized clinical trial was conducted after obtaining approval from the Chinese Clinical Trial Registry (
PMC10653976
2.1.1. Inclusion Criteria
lung cancer, ASAs
LUNG CANCER
Patients with lung cancer undergoing elective thoracoscopic surgery, age over 18 years, BMI 18–40 kg/m2, and American Society of Anesthesiologists (ASAs) physical status II-III were enrolled in this study.
PMC10653976
2.1.2. Inclusion Criteria for Chronic Postsurgical Pain
tissue injury, Pain
Pain that occurs or increases after surgery or tissue injury lasts at least three months and is limited to the surgical or injury site.
PMC10653976
2.1.3. Exclusion Criteria
allergic, infection, allergies, coagulation system disease, cardiovascular or hepatorenal insufficiency
INFECTION, MORBID OBESITY, COAGULOPATHY, ALLERGIES
Contraindications to CPVB included allergies to local anesthetics, infection, or coagulopathy; allergic constitution; severe cardiovascular or hepatorenal insufficiency; coagulation system disease; morbid obesity (BMI >40 kg/m
PMC10653976
2.1.4. Randomization and Blinding
The computer random number method generated a total of 113 random numbers (ranging from 1 to 113). The first 56 numbers were assigned to the CPVB group, and the remaining 57 digits were assigned to the CWI group. Patients ranked the numbers sequentially according to the experiment, and statistical analysis was finally ...
PMC10653976
2.2. Anesthesia Procedure
After patient arrival at the operation room, an intravenous sodium lactate Ringer's solution infusion was initiated and a radial artery catheter was placed. Standard monitoring, including evaluation of pulse oxygen saturation (SpO
PMC10653976
2.3. Ultrasound-Guided CPVB
hypoalgesia, hypothermia, NRS, reflux
REFLUX
In the CPVB group, ultrasound-guided CPVB was performed with the patient in the lateral position by the same anesthesiologist at the end of the operation. After identifying the paravertebral space of the proposed level of the intercostal skin incision, a 20-gauge catheter (B. Braun Melsungen AG, 34209 Melsungen, German...
PMC10653976
3. Outcome Measures
PMC10653976
3.1. The Main Outcome Measures
CPSP, NRS, pain
The incidence of CPSP was assessed by the number of positive cases of CPSP (NRS ≥ 1 and 3 months postoperatively). The intensity of CPSP can be indirectly assessed by the scores of the effects of pain on daily life and the level of pain treatment measures [The effect of pain on daily life had four grades: grade A (no e...
PMC10653976
3.2. The Secondary Outcome Measures
CPSP
Secondary outcome measures were as follows: (1) general information of the patients; (2) the NRS score for rest and activity at 12, 18, and 24 hours as well as 2, 3, and 7 days postoperatively; (3) the Barthel Activities of Daily Living (ADL) score for the activity level at 1The patients were divided into two groups ac...
PMC10653976
4. Sample Size Calculation
CPSP
CHRONIC PAIN
Sample size calculation was performed using PASS 15.0 (Stata Corp. LP, College Station, Texas, USA), which relied on the chronic pain incidence at 3 months after surgery. According to our preliminary results of 38 cases (19 cases in the CPVB group and 19 cases in the CWI group), we found that the incidence of CPSP at 3...
PMC10653976
5. Statistical Analysis
All statistical analyses were performed using the Statistical Package for the Social Sciences version 26.0 (SPSS Inc., Chicago, USA). Parametric variables were compared by an independent
PMC10653976
6. Results
PMC10653976
6.1. Patient Characteristics
lung cancer, chronic pain
LUNG CANCER, CHRONIC PAIN
Between August 2020 and January 2021, 113 patients with lung cancer undergoing elective thoracoscopic surgery were enrolled in our study. Seven patients were excluded for the following reasons: history of chronic pain (
PMC10653976
6.2. The Incidence and Intensity of CPSP
CPSP
The CPSP incidence is shown in
PMC10653976
6.3. Pain Management within 7 Days after Surgery
pain
Acute pain scores at rest are shown in Acute pain scores with activity are shown in
PMC10653976
6.4. Barthel ADL Scores within 7 days Postoperatively
The Barthel ADL scores within 7 days postoperatively are shown in
PMC10653976
6.5. Long-Term Quality of the Life Score
The two groups were comparable regarding the SF-12 scores, but there were no differences in long-term quality of life scores at 3, 6, and 9 months postoperatively (
PMC10653976
6.6. The Relationship between Acute Pain Intensity and Chronic Pain Incidence
CPSP
GROUP B
There were 48 patients with NRS-R scores >2 (Group A) and 32 patients with NRS-R < 2 (Group B) on the first postoperative day. However, there were 20 (41.67%) patients with CPSP in Group A at 3 months, 16 (33.33%) at 6 months, and 11 (22.92%) at 9 months, whereas there were only 5 (15.63%) patients with CPSP in Group B...
PMC10653976
6.7. Postoperative-Related Data
During the 48-hour postoperative period, the CPVB group used significantly less rescue analgesia (2/40 vs. 13/40,
PMC10653976
7. Discussion
postoperative pain, visceral pain, acute pain, pain, lung cancer, chronic pain
LUNG CANCER, CHRONIC PAIN
Our study revealed that CPVB can significantly reduce the chronic pain incidence and intensity at 3, 6, and 9 months after surgery and provide better acute pain relief up to 7 days after surgery when compared to local anesthetic continuous infusion but had no effect on long-term quality of life in patients with lung ca...
PMC10653976
7.1. Limitations
neuropathic pain, nerve block, pain
CHRONIC PAIN, INFILTRATION
Some limitations of this study need to be considered. First, the sample size of our study (a single-center investigation) is slightly small, which may have biased the research results. Second, there was no blank control group in our clinical study because our local ethics committee believes that it is immoral to use no...
PMC10653976
8. Conclusion
CPSP, pain
Ultrasound-guided CPVB can reduce the number of patients receiving remedial analgesics after thoracoscopic surgery, promote the quality of early postoperative rehabilitation, and reduce the incidence and intensity of CPSP within 9 months after thoracoscopic surgery by better acute pain control, but there was no signifi...
PMC10653976
Acknowledgments
THORACIC
We sincerely thank all the doctors and nurses in the Thoracic Surgery Department of the First Affiliated Hospital of Chongqing Medical University for their kind support and help, which made us able to complete this clinical trial successfully. This work was supported by funding from the National Key Clinical Specialty ...
PMC10653976
Data Availability
The datasets generated and/or analyzed during the current study are not publicly accessible but are available from the corresponding author upon reasonable request.
PMC10653976
Conflicts of Interest
The authors declare that they have no conflicts of interest.
PMC10653976
Authors' Contributions
Postoperative pain, Zhiqiao, CPSP, pain
CHRONIC PAIN, INFILTRATION
Jin Gao designed the study. Huan Luo and Wei Ran wrote the first draft of the manuscript. Huan Luo and Wei Ran performed the data analysis and statistical analysis. Zhiqiao Wang and Yonggang Hao helped collect the data. Jin Gao and Ning Liang conducted the data interpretation. Ping Li and Xia Yin managed the literature...
PMC10653976
Background
Nursing home residents (NHR) show high rates of polypharmacy. The HIOPP-3-iTBX study is the first cRCT on medication optimization in nursing homes (NH) in Germany. The intervention did not result in a reduction of PIM and/or antipsychotics. This analysis looks at structure quality in the HIOPP-3-iTBX study participants...
PMC10520111
Aims
Evaluation of structure quality as part of a cluster-randomized controlled intervention study.
PMC10520111
Methods
Structure quality in multiprofessional teams from
PMC10520111
Results
The presence of a nurse with one of the additional qualifications
PMC10520111
Conclusions and discussion
The results support the known role of nursing qualification in the quality and safety of care. Further studies need to look more closely at how use is made of the additional qualifications within the multiprofessional teams. Perspectively, the results can contribute to the development of quality standards in NH in Germ...
PMC10520111
Supplementary Information
The online version contains supplementary material available at 10.1007/s40520-023-02513-9.
PMC10520111
Keywords
Open Access funding enabled and organized by Projekt DEAL.
PMC10520111
Background
Aging societies worldwide are associated with an increase in the rate of polypharmacy, which is frequently characterized by the concurrent use of five or more medications [The risk of receiving PIM is also higher in NHR compared to older people living in the community [Drug management in NHR is a complex interprofessio...
PMC10520111
Methods
PMC10520111
HIOPP-3-iTBX study
MAY
Between May 2018 and July 2019, a cRCT was conducted in 44 German NH at four study centers (the Institutes for General Practice in Düsseldorf, Hannover, Rostock, and Tübingen; Germany) [
PMC10520111
Analyzed data
As a part of the project evaluation, questionnaires addressing structural aspects in HIOPP-3-iTBX study participating FD (In the present analysis, all completed questionnaires by participating nursing home directors, FDs, and pharmacists at baseline were included.
PMC10520111
Statistical methods
REGRESSION
Descriptive results are presented as absolute frequencies and percentages or as mean ± standard deviation (SD). To evaluate the association of different factors with the proportion of NHR receiving a PIM/antipsychotic at baseline, a mixed model logistic regression was applied. In the logistic regression model data from...
PMC10520111
Discussion
dementia, pain
To our knowledge, HIOPP-3-iTBX is the first randomized study to investigate structures, processes, and outcomes of an interprofessional medication management in NH in Germany. The complex intervention in HIOPP-3-iTBX did not lead to a reduction of PIM and/or antipsychotics in the participating NHR [The analysis showed ...
PMC10520111
Limitation
Pain
Only a few nurses in the HIOPP-3-iTBX study had one of the additional qualifications Pain Nurse (Data from the HIOPP-3-iTBX study does not allow for a description more detailed how the trained nursing professionals apply their knowledge in daily care. In addition, there is no data on whether the presence of nurses with...
PMC10520111
Conclusions
pain
Medication management in NH is an interprofessional and complex task. The results of this analysis of the HIOPP-3-iTBX study support the known role of nursing qualification in the quality and safety of care. The analysis showed that advanced training in the field of pain and geriatrics in nursing professionals was asso...
PMC10520111
Acknowledgements
We would like to thank all participating NH as well as participating NHR and their careers. We would also like to thank all nursing staff in the homes, as well as all nursing services, FDs, medical assistants, and pharmacists for their participation.
PMC10520111
Funding
Open Access funding enabled and organized by Projekt DEAL. This study was funded by the Innovation Fund of the Joint Federal Committee (Grant No.: 01VSF16017). The study was registered in the German Register of Clinical Trials (DRKS00013588).
PMC10520111
Declarations
PMC10520111
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
PMC10520111
Ethical approval
The Ethics Committee of the Hannover Medical University approved the Masters Ethics Application (No. 7655).
PMC10520111
Statement of human and animal rights
This study was performed in line with the principles of the Declaration of Helsinki and results are reported in regard of the CONSORT Statement. The Medical Research Council (MRC) Guideline “Developing and evaluating complex interventions—new guidance” was applied in the intervention development.
PMC10520111
Informed consent
Informed consent was obtained from all individual participants included in the study or their legal guardians.
PMC10520111
References
PMC10520111
Objective:
Web-based dietary interventions could support healthy eating. The Advice, Ideas and Motivation for My Eating (Aim4Me) trial investigated the impact of three levels of personalised web-based dietary feedback on diet quality in young adults. Secondary aims were to investigate participant retention, engagement and satisfa...
PMC10346011
Design:
Randomised controlled trial.
PMC10346011
Setting:
Web-based intervention for young adults living in Australia.
PMC10346011
Participants:
SECONDARY
18–24-year-olds recruited across Australia were randomised to Group 1 (control: brief diet quality feedback), Group 2 (comprehensive feedback on nutritional adequacy + website nutrition resources) or Group 3 (30-min dietitian consultation + Group 2 elements). Australian Recommended Food Score (ARFS) was the primary out...
PMC10346011
Results:
Participants (
PMC10346011
Conclusion:
Recruiting and retaining young adults in web-based dietary interventions are challenging. Future research should consider ways to optimise these interventions, including co-design methods.
PMC10346011
Keywords
Young adults have lower diet quality compared with all other age groupsDietary interventions targeting dietary improvement in young adults are needed. A systematic review of twenty-four nutrition intervention studies among university/college students found no high-quality studiesAdopting and maintaining positive dietar...
PMC10346011
Methods
PMC10346011
Trial design
The Advice, Ideas and Motivation for My Eating (Aim4Me) was a 12-month prospective, randomised, open, blinded endpoint trial. Potential participants were recruited from across Australia, then screened using a web-based eligibility survey. Those interested and eligible provided electronic informed consent and contact de...
PMC10346011
Participants
Eligibility criteria included: aged between 18 and 24 years, had a BMI ≥ 18·5 kg/mParticipants were recruited nationally across Australia using social media platforms (paid targeted ads on Facebook and Instagram) and from universities, organisations and communities who interact with young adults via links and flyers, a...
PMC10346011
Randomisation
Eligible participants were randomly allocated (1:1:1) to one of the three groups. Randomisation occurred in random permuted blocks of varying size and was stratified by postcode location (using the Monash Modified Model)
PMC10346011
Interventions
PMC10346011
Group 1 (control): brief diet quality feedback
Group 1 participants were provided with a link to complete the HEQ (
PMC10346011
Group 2: comprehensive feedback on nutritional adequacy + Aim4Mewebsite nutrition resources
Participants in Group 2 were given access to the
PMC10346011
Group 3: dietitian consultation + group 2 elements
Participants randomised to Group 3 also had access to the
PMC10346011
Assessments
Socio-demographic characteristics were collected at baseline via an online survey administered through the
PMC10346011
Outcome measures
SECONDARY
The primary outcome was diet quality at baseline and 3, 6 and 12 months, assessed using the ARFS. Secondary outcomes included ARFS subscales (vegetables, fruit, meat, meat alternatives, grains and dairy foods) and percentage energy (%E) from nutrient-rich core foods. Participants were sent up to three email reminders o...
PMC10346011
Statistical methods
SECONDARY
Data were analysed using IBM SPSS Statistics 27 (IBM Corp.). Demographic and baseline characteristics were reported for participants across the three study groups as mean (Generalised linear mixed models were used to analyse the primary outcome (ARFS total) and secondary outcomes (ARFS subscales, percentage energy from...
PMC10346011
Results
PMC10346011
Recruitment
Figure CONSORT diagram describing study design and flow of participants through the 12-month
PMC10346011
Participant characteristics
Participant characteristics are provided in Table Characteristics of participants enrolled at baseline in the ARFS, Australian recommended food score; AUD, Australian dollars; EDNP foods, energy-dense nutrient-poor foods; MVPA, moderate to vigorous physical activity; SEIFA, socio-economic indexes for areas.Higher perc...
PMC10346011
Participant retention
Participant retention was low, with 32 (3 %) participants across the sample completing the 3-month follow-up AES, 88 (9 %) completing the 6-month follow-up AES and 141 (14 %) completing the 12-month follow-up AES. Retention at 3, 6 and 12 months was 2 %, 10 % and 16 % for Group 1, 4 %, 8 % and 12 % for Group 2, and 4 %...
PMC10346011
Diet quality outcomes
SECONDARY
Overall, no significant ( Mean (95 % CI) change in primary (ARFS) and secondary outcomes within groups and between groups (intention-to-treat population) over time in the Aim4Me trialARFS, Australian recommended food score. Time differences were calculated as (3 months minus baseline), (6 months minus baseline) and (12...
PMC10346011
Sensitivity analyses
SECONDARY
Results for the per-protocol sensitivity analyses comparing participants in Group 1 ( Per-protocol sensitivity analysis investigating mean (95 % CI) change in primary (ARFS) and secondary outcomes within groups and between groups comparing Group 1 (control- brief feedback report) with Groups 2 and 3 combined (website +...
PMC10346011
Participant engagement
Engagement with the
PMC10346011
Participant satisfaction
Feedback was provided by Group 1 (In Group 3, process evaluation data were available for thirty-three participants (63 %) who completed the dietitian consultation. Most (82 %) reported that the video platform was easy to use and that the picture and sound quality were acceptable (85 % and 79 %, respectively). Most felt...
PMC10346011