Rejected

The cycle threshold (Ct) in quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR) is inversely correlated to the amount of viral nucleic acid or viral load and can be regarded as an indicator of infectivity. We examined the association of socio-demographic and clinical characteristics of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) polymerase chain reaction (PCR) positive cases with PCR cycle threshold (Ct) values at the time of diagnosis. SARS-CoV-2 cases reported between 12 October 2020 and 24 January 2021 in Regensburg were analyzed employing bivariate and multivariable methods. We included 3,029 SARS-CoV-2 cases (31% asymptomatic at diagnosis) and analyzed the association of case characteristics with Ct values in 2,606 cases. Among symptomatic patients, cough (38.0%), rhinitis (32.4%), headache (32.0), and fever/chills (29.9%) were the most frequent complaints. Ct values ≤20 were more frequent in symptomatic cases (20.9% vs. 11.3%), whereas Ct values >30 were more common in asymptomatic cases (32.6% vs. 18.0%). Ct values >20 and ≤30 were most common in symptomatic and asymptomatic cases (48.0% vs 40.7%). We observed lower median Ct values of E and N gene in symptomatic cases. In a random forest model, the total number of symptoms, respiratory symptoms, and age were most strongly associated with low Ct values. In conclusion, certain symptoms and age were associated with lower Ct values. Ct values can be used as a pragmatic approach in estimating infectivity at the first notification of a case and, thus, in guiding containment measures.

Current treatments for chronic pancreatitis focus on symptom management and therapeutics targeting disease reversal are lacking. Given the role of the cyclooxygenase-2 (COX-2) enzyme in producing prostaglandin E (PGE), a key component in the inflammatory pathway of chronic pancreatitis, this study evaluates the physiologic effect of oral indomethacin, a COX-2 inhibitor, on PGE levels in pancreatic fluid.

Chronic pelvic pain (CPP) and chronic pelvic pain syndrome (CPPS) do not have a definite cause, even if their impact on quality of life was demonstrated. Furthermore, there is evidence of myofascial dysfunctions in a large number of CPP/CPPS, so that the role of fascia can be hypothesized.

After anaerobic digestion of excess sludge, dissolved organic matter is absorbed and used, but the treatment of refractory sludge is a headache. Oxidative acid (performic acid and hydrochloric acid) hydrolysis process can effectively prepare amino acids from refractory sludge. During the preparation process, insoluble proteins in sludge were turned into soluble proteins and peptides. All of them eventually hydrolyze into amino acids. The optimum conditions in the single factor experiment were as follows: the temperature of 110 °C, the reaction time of 24 h, and hydrochloric acid (HCl) concentration of 6 M. The results showed that the maximum total yield of amino acids from refractory sludge was 94.76%. In the orthogonal experiment, the maximum total yield of amino acids was 97.20% under the optimum conditions of temperature of 113.45 °C, the reaction time of 26.79 h, and 5.92 M HCl. The recovery rate of purity amino acids was 17.16 g per 100 g of dry sludge. The recovery rate of the hydrochloric acid was approximately 70%. There were 17 kinds of amino acids in the hydrolysate, which could be used as deodorants, food additives, preservatives and corrosion inhibitors. This new technology is expected to be very effective in the treatment of refractory sludge.

Postoperative pain after total hip arthroplasty can affect postoperative rehabilitation and delay hospital discharge. The objective of this study is to compare pericapsular nerves group (PENG) block with pericapsular infiltration (PAI) and plexus nerve block (PNB) for postoperative pain management, response to physical therapy, opioid consumption, and length of hospital stay after a primary total hip arthroplasty.

This study investigated whether a novel multi-injection intertransverse process block could provide non-inferior analgesia and recovery quality following major breast cancer surgery compared with the multi-injection thoracic paravertebral block.

Previous literature suggests that kidney transplant recipients (KTRs) do not use the majority of opioid tablets prescribed after transplant surgery. This study analyzed the effectiveness of a new pain management guidance in KTRs after discharge from transplant surgery at a renal transplant center. The single center pre-, post- study compared the number of opioid refill requests, patient-reported pain control, multimodal analgesic agents, and opioid tablets prescribed at discharge in both pre- and post- cohorts. A total of 127 patients were included. Data was collected through standardized patient interviews and chart review from electronic medical records. The pre-guidance and post-guidance cohorts had no detectable difference in refill requests (p = 0.365) nor pain control (p = 0.324) post-discharge. The post-group had a significant reduction in opioid tablets prescribed at discharge (22 tablets ± 10 vs 10 tablets ± 2, p = <0.0001) with a significant increase in acetaminophen (p = 0.005) and lidocaine patches (p = <0.0001) prescribed at discharge. Both groups used a mean of three opioid tablets within the first week after discharge. The guidance resulted in 700 fewer opioid tablets in the community during the study time frame, with no difference in pain control nor refill requests after discharge.

Epidemiological research has found that between 5 and 12 percent of the population suffers from chronic rhinosinusitis. Patients are dealing with local side effects such as nasal dryness, sporadic sneezing, and nasal pain in addition to the inflammation. The aim of this study was to synthesize a polymer based on hyaluronic acid in order to provide lubrication combined with a ligand leading to a covalent binding on the nasal mucosa. Hyaluronic acid (HA) was modified with L-cysteine ethyl ester hydrochloride (CYS) via amid bond formation. Ellman's assay, together with spectroscopic techniques like IR and H NMR, confirmed that HACys had been successfully synthesized. It was demonstrated that HACys is safe for administration on the nasal mucosa. The mucoadhesive potential was determined by 3.26-fold with the rotating cylinder assay and 1.4-fold in terms of bioadhesive examination, respectively. Further, the stability of the modified polymer was improved by 7.6-fold compared to the unmodified polymer. Spraying the formulation on the nasal mucosa, the residence time of a model drug was 1.74-fold prolonged at the site of action compared to unmodified polymer. In light of these findings, modified hyaluronic acid (HACys) displayed compelling properties such as lubricity, targeted application, long-lasting effect, and safety and therefore could be an excellent candidate for nasal application.

To assess the prevalence of foot IF in RMD patients with foot pain.

This systematic review describes herpes zoster (HZ) economic burden in terms of healthcare resource use and cost outcomes in the Latin America and Caribbean (LAC) region. We searched online databases from 1 January 2000 to 20 February 2020 to identify eligible publications. We identified 23 publications that reported direct costs, indirect costs, and resources associated with HZ and its complications. The primary direct medical resources reported in the different studies were visits to doctors, transportation, days in the hospital, nursing, medication schedules, and physical therapy. Direct total costs per patient ranged from $99.99 to $4177.91. The highest cost was found in Brazil. Direct costs are, in average, 81.39% higher than indirect costs. The cost per patient that includes postherpetic neuralgia treatment is 115% higher on average for the directs and 73% for the indirect costs. Brazil reported a higher total cost per patient than Argentina and Mexico, while for indirect costs per patient, Brazil and Argentina had higher costs than Mexico, respectively. A meta-analysis on the number of days due to HZ hospitalization, performed on non-immunosuppressed patients over 65 years of age from three studies, resulted in a cumulative measure of 4.5 days of hospitalization. In the LAC region, the economic burden of HZ and associated complications is high, particularly among high-risk populations and older age groups. Preventative strategies such as vaccination could help avoid or reduce the HZ-associated disease economic burden in the LAC region.