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Design This study is a double-blind, single-centre, split-mouth, prospective randomised control trial. In total, 48 patients had bilateral third molars removed during two separate operations at least 21 days apart by the same maxillofacial surgeon. During the control operation, the tooth was irrigated with saline at 25°C. During the test operation, patients were randomised to tooth irrigation with saline at either 10°C (n = 24) or 4°C (n = 24). Local anaesthetic, flap design, burr design and sutures remained consistent throughout. Patients were prescribed amoxicillin, chlorhexidine and were advised to take paracetamol as needed. The patients remained blinded to which test group they were randomised to and to the order of the control or test operations performed. Participants self-recorded analgesia use and post-operative pain daily for seven days using a visual analogue scale (VAS). A second maxillofacial surgeon examined patients on days one, three and seven. Facial swelling was assessed by measuring the distance between various soft tissue points compared to pre-operative levels. Trismus was determined by measuring maximum inter-incisal opening compared to pre-operative levels.Case selection In total, 28 female and 20 male medically fit adult patients with a mean age of 24.6 ± 3.8 with bilateral mandibular asymptomatic third molar teeth were selected. Second molars with periodontal probing depths >4 mm or impacted third molars associated with cysts or tumours were excluded. Patients had no antibiotic prescription in the preceding month nor analgesic consumption in the 12 hours before surgery.Data analysis The Shapiro-Wilk test was used to evaluate if the sample fit a normal distribution. Relationships between the categorical variables of the groups was tested using chi-square statistics. Data comparisons were examined with the Duncan, Kriskal-Wallis, Dunn and Friedman test (p <0.05).Results The median duration of the control and test group operations were similar (p = 0.051). Test group patients reported lower pain VAS values and consumed less analgesics compared to the control groups (p = 0.001), with the lowest values seen in the 4°C group (p <0.001). A greater decrease in trismus levels was also seen on day three and seven in the test groups (p <0.001) compared to the control group (p = 0.07). Swelling was greatest in the control group (p <0.001) and reduced on day seven (p <0.001) in all groups. While trismus and swelling values were lower in the 10°C test group compared to the control (p <0.001), the lowest values of these parameters at all time points was in the 4°C group (p <0.001).Conclusions Early complications following third molar removal include facial swelling, trismus and pain. In this study, intraoperative cooled saline irrigation to 4°C and 10°C was more effective than saline irrigation at 25°C in reducing the intensity of these conditions.

[Purpose] In this pilot study, we investigated the effectiveness of physical therapist-delivered acceptance and commitment therapy in older outpatients with knee osteoarthritis and chronic pain. [Participants and Methods] This single-center, open-label, parallel-group pilot randomized controlled trial included 30 patients assigned to the physical therapist-delivered acceptance and commitment therapy group (n=15) and the usual care physical therapy-only group (n=15). Both treatments were administered once a week for 8 weeks. Evaluation was performed 4 weeks before intervention, pre-intervention, post-intervention, and 4 weeks after intervention. The primary outcome was diagnosis of a physical disability, and secondary outcomes included psychological inflexibility, pain intensity, anxiety, depression, physical function, and objectively measured physical activity. [Results] Physical therapist-delivered acceptance and commitment therapy had a limited effect on physical disability, although we observed a favorable tendency. With regard to secondary outcomes, physical therapist-delivered acceptance and commitment therapy did not show significant effects. Notably, 15 patients withdrew from this study and 6 were diagnosed with coronavirus disease. [Conclusion] Physical therapist-delivered acceptance and commitment therapy did not appear to show significant effects in the present study. It is necessary to correct these issues in this study, and future studies are warranted to investigate the effects of this therapy.

Oral health is an integral part of every child's overall wellness and affects their development, family, and social life, as well as school performance; it should be addressed at every well-child visit. Tooth decay continues to be the most prevalent yet preventable chronic disease of childhood; it leads to unnecessary pain, infections, poor academic performance, and frequent school absences and adds an unnecessary financial burden to the health care system. Despite improvements in oral health, disparities continue to exist for children from minority backgrounds and lower socioeconomic status. As primary care providers for children, it is important to understand factors that lead to oral disease and be able to anticipate, treat, and, most important, prevent oral disease in children early in their development. .

Remotely delivered pain management programmes have been offered in place of in-person programmes by many chronic pain services since the onset of the COVID-19 pandemic. There is a lack of evidence regarding the acceptability of these programmes. In this evaluation, we have explored patients' acceptability of a remotely delivered pain management programme for patients with persistent musculoskeletal pain.

This study demonstrates that intravenous infusion of the cell-penetrant thiol ester, L-cysteine ethyl ester (L-CYSee), to adult male Sprague-Dawley rats elicited (a) minor alterations in frequency of breathing, expiratory time, tidal volume, minute ventilation, or expiratory drive but pronounced changes in inspiratory time, end-inspiratory and expiratory pauses, peak inspiratory and expiratory flows, EF, relaxation time, apneic pause, inspiratory drive and non-eupneic breathing index, (b) minimal changes in arterial blood-gas (ABG) chemistry (pH, pCO, pO, SO) and Alveolar-arterial (A-a) gradient (index of alveolar gas exchange), and (c) minimal changes in antinociception (tail-flick latency). Subsequent injection of morphine (10 mg/kg, IV) elicited markedly smaller effects on the above parameters, ABG chemistry, and A-a gradient in rats receiving L-CYSee, whereas morphine antinociception was not impaired. Infusions of L-cysteine or L-serine ethyl ester (oxygen rather than sulfur moiety), did not affect morphine actions on ABG chemistry or A-a gradient. L-CYSee (250 μmol/kg, IV) injection elicited dramatic changes in ventilatory parameters given 15 min after injection of morphine in rats receiving L-CYSee. Our findings suggest that (a) L-CYSee acts in neurons that drive ventilation, (b) L-CYSee reversal of the adverse actions of morphine on ventilation, ABG chemistry and A-a gradient may be via modulation of intracellular signaling pathways activated by morphine rather than by direct antagonism of opioid receptors since morphine antinociception was not diminished by L-CYSee, and (c) the thiol moiety of L-CYSee is vital to efficacy, (d) intracellular conversion of L-CYSee to an S-nitrosylated form may be part of its mechanism of action.

To study the effect and underlying mechanisms of Chinese medicine Yanghe decoction on pain relief in a rat model of bone metastasis of breast cancer induced by michigan cancer foundation-7 (MCF-7).

To analyse the causes of hyperprolactinaemia in patients with symptoms compatible with hyperprolactinaemia evaluated in a primary care setting.

(FPPFC) was developed to assess quality of physician-family end-of-life communication in nursing homes. However, its validity has been tested only in the USA and the Netherlands. The aim of this paper is to evaluate the FPPFC construct validity and its reliability, as well as the psychometric characteristics of the items comprising the scale. Data were collected in cross-sectional study in Belgium, Finland, Italy, the Netherlands and Poland. The factorial structure was tested in confirmatory factor analysis. Item parameters were obtained using an item response theory model. Participants were 737 relatives of nursing home residents who died up to 3 months prior to the study. In general, the FPPFC scale proved to be a unidimensional and reliable measure of the perceived quality of physician-family communication in nursing home settings in all five countries. Nevertheless, we found unsatisfactory fit to the data with a confirmatory model. An item that referred to advance care planning performed less well in Poland and Italy than in the Northern European countries. In the item analysis, we found that with no loss of reliability and with increased coherency of the item content across countries, the full 7-item version can be shortened to a 4-item version, which may be more appropriate for international studies. Therefore, we recommend use of the brief 4-item FPPFC version by nursing home managers and professionals as an evaluation tool, and by researchers for their studies as these four items confer the same meaning across countries.