Anti-emetic effect of ondansetron and palonosetron in thyroidectomy: a prospective, randomized, double-blind study

BACKGROUND

Palonosetron is a new potent 5-hydroxytryptamine 3 antagonist. Although this drug is thought to be more effective in patients receiving opioid-based patient-controlled analgesia (PCA), clinical data are lacking. This study compared the effects of i.v. ondansetron and palonosetron administered at the end of surgery in preventing postoperative nausea and vomiting (PONV) in high-risk patients receiving i.v. PCA after thyroidectomy.

METHODS

A total of 100 female non-smoking subjects were randomly assigned into a palonosetron group or an ondansetron group. Ondansetron was given as an 8 mg bolus and 16 mg was added to the i.v. PCA mixture. In the palonosetron group, 0.075 mg was injected as a bolus only. Fentanyl-based PCA was provided for 24 h after operation. The incidence of nausea and vomiting, severity of nausea, requirement for rescue anti-emetics, and adverse effects were evaluated during 0-2 and 2-24 h.

RESULTS

The incidence of PONV during the 24 h postoperative period was lower in the palonosetron group than in the ondansetron group (42% vs 62%, P=0.045). No differences were observed between the groups during the first 2 h. However, the incidence of nausea and vomiting and nausea severity were significantly lower in the palonosetron group than in the ondansetron group during 2-24 h. The only difference in the use of rescue anti-emetics was at 2-24 h (10% with palonosetron compared with 28% with ondansetron, P=0.02).

CONCLUSIONS

Palonosetron is more effective than ondansetron for high-risk patients receiving fentanyl-based PCA after thyroidectomy, especially 2-24 h after surgery.

The prevalence of anatomical variations that can cause inadvertent dural puncture when performing caudal block in Koreans: a study using magnetic resonance imaging

The purpose of this study was to investigate the prevalence of the anatomical abnormalities that can induce inadvertent dural puncture when performing caudal block. The anatomy of the lumbo-sacral area was evaluated using magnetic resonance imaging. In 2462 of the 2669 patients imaged, the dural sac terminal was located between the upper half of the 1st sacral vertebra and the lower half of the 2nd sacral vertebra. In 22 cases (0.8%), the dural sac terminal and the spinal canal were located at or below the 3rd sacral vertebra, and these were cases of simple anatomical variations. As regards pathologic conditions, there was one case of sacral meningocoele and 46 cases of sacral perineural cyst. In 21 cases (0.8%) out of the 46 perineural cyst cases, the cyst could be found at or below the 3rd sacral vertebra level. Inadvertent dural puncture may happen when performing caudal block in patients with such abnormal anatomy.

Widespread cortical thinning in patients with neuromyelitis optica spectrum disorder

BACKGROUND AND PURPOSE

Studies on cortical involvement and its relationship with cognitive function in patients with neuromyelitis optica spectrum disorder (NMOSD) remain scarce. The objective of this study was to compare cortical thickness on magnetic resonance imaging (MRI) between patients with NMOSD and multiple sclerosis (MS) and to investigate its relationship with clinical features and cognitive function.

METHODS

This observational clinical imaging study of 91 patients with NMOSD, 52 patients with MS and 44 healthy controls was conducted from 1 December 2013 to 30 April 2015 at the institutional referral center. Three tesla MRI of the brain and neuropsychological tests were performed. Cortical thickness was measured using three-dimensional surface-based analysis.

RESULTS

Both sets of patients exhibited cortical thinning throughout the entire brain cortex. Patients with MS showed a significantly greater reduction in cortical thickness over broad regions of the bilateral frontal and parieto-temporal cortices and the left precuneus compared to those with NMOSD. Memory functions in patients with MS were correlated with broad regional cortical thinning, whereas no significant associations were observed between cortical thickness and cognitive function in patients with NMOSD.

CONCLUSIONS

Widespread cortical thinning was observed in patients with NMOSD and MS, but the extent of cortical thinning was greater in patients with MS. The more severe cortical atrophy may contribute to memory impairment in patients with MS but not in those with NMOSD. These results provide in vivo evidence that the severity and clinical relevance of cortical thinning differ between NMOSD and MS.

Estimated long-term dietary exposure to lead, cadmium, and mercury in young Korean children

BACKGROUND

Controlling for day-to-day variation is a key issue in estimating long-term dietary exposure to heavy metals using 24-hour recall (24HR) data from a relatively small number of days.

OBJECTIVES

This study was conducted to estimate long-term dietary exposure to lead, cadmium and mercury among Korean children using the Iowa State University (ISU) method and to assess the contributions of different food groups to heavy metal intake.

METHODS

We analyzed 2 days of 24HR data from 457 children between 0 and 6 years of age in 2010. Using bootstrapped concentration data for 118 representative foods, 93.5% of total intake was included in the exposure estimates in this study. Using the 2-day exposure data, we estimated long-term exposure by controlling for within-individual variation using the ISU method.

RESULTS

The long-term dietary exposure estimates (mean±standard deviation) for lead, cadmium, and mercury were 0.47±0.14, 0.38±0.20, and 0.22±0.08 μg/kg bw/day, respectively. For lead and cadmium, the percentages of children whose exposure was greater than the reference value were 35 and 42%, respectively. Fruits were an important source of lead exposure, and cereal and fish and shellfish made the greatest contributions to the total cadmium and mercury exposure.

CONCLUSIONS

Our findings also suggest that the long-term exposure to lead and cadmium was somewhat greater than the reference values, whereas mercury exposure was well below than the reference value in this population. Further studies may be necessary to evaluate the food items contributing to heavy metal exposure, and continuous monitoring is needed to ensure the safety of food intake and dietary patterns among vulnerable groups in Korea.

Alpha-fetoprotein is a significant prognostic factor for gastric cancer: Results from a propensity score matching analysis after curative resection

BACKGROUND

Prognosis of alpha-fetoprotein positive gastric cancer (AFPP-GC) remains elusive so far due to disparities in cohort size and baseline characteristics in previous studies. A propensity score matching (PSM) analysis as well as multivariable model was performed for unbiased evaluation of the outcome in AFPGC.

METHODS

Among 3034 gastric cancer patients who underwent curative gastric cancer surgery (R0, M0) at the National Cancer Center, Korea between 2002 and 2007, we identified 97 patients being positive for AFP either by elevation of serum-AFP levels >10 μg/L or by immunohistochemical staining. Due to marked disparities in baseline characteristics and cohort size, propensity-score-matching was performed which matched 87 AFPP-GC patients to the same number of AFP-negative gastric cancer (AFPN-GC) patients. Baseline characteristics were compared using χ²-test. Survival curves were compared using the Kaplan-Meier-method and multivariable regression analysis was performed to evaluate the effect of AFP-positivity while adjusting the effects of confounding variables.

RESULTS

AFPP-GC and AFPN-GC patients revealed marked disparities in patient cohorts. After PSM, groups were balanced for age, sex, tumor size, BMI, tumor location, grade of differentiation, presence of lymphatic vessel infiltration (LVI), Lauren histologic type and stage distribution. In multivariable regression analysis of the PSM-groups, only AFP-positivity and pathologic stage were predictive for overall survival (HR 2.98, CI 95% {1.7-5.1}, p < 0.0001). Five-year-survival rates were significantly worse for AFPP-GC patients (57.9% vs. 76.1%, p = 0.014). Recurrence was significantly more frequent in AFPP-GC patients (p = 0.003).

CONCLUSION

AFP can be considered as an independent negative predictor of overall and recurrence-free survival in patients with gastric cancer.

The role of self-disclosure by peer mentors: Using personal narratives in depression care

OBJECTIVE

Self-disclosure is recognized as an important aspect of peer support, but little is known about its use by peers. This study aimed to qualitatively understand peer self-disclosure in the context of depression care delivery to older adults.

METHODS

69 audio-recordings of peer-client meetings were coded for self-disclosure using the Roter Interaction Analysis System (RIAS). Peer self-disclosure was defined as a statement describing personal life experience with physical and/or emotional relevance for the client. A total of 3421 discrete statements were organized into 770 disclosure episodes. The episodes were qualitatively analyzed to identify themes related to the content and function of self-disclosure within the peer-counseling context.

RESULTS

Peer self-disclosure was used to 1) counsel through reframing perspectives, modeling positive behaviors, offering coping skills, and sharing mental health resources and health information; 2) establish rapport by emphasizing similarities unrelated to depression; and 3) show empathy and understanding of personal struggles. In addition, self-disclosure rarely only focused on the peer experience without relevance for the client.

CONCLUSIONS & PRACTICE IMPLICATIONS

Peer self-disclosure can be purposively used in depression care delivery with older adults. Training and supervision in appropriate self-disclosure should be provided to peers to ensure purposive use.

Waste-to-Fuels: Pyrolysis of Low-Density Polyethylene Waste in the Presence of H-ZSM-11

Herein, the pyrolysis of low-density polyethylene (LDPE) scrap in the presence of a H-ZSM-11 zeolite was conducted as an effort to valorize plastic waste to fuel-range chemicals. The LDPE-derived pyrolytic gas was composed of low-molecular-weight aliphatic hydrocarbons (e.g., methane, ethane, propane, ethylene, and propylene) and hydrogen. An increase in pyrolysis temperature led to increasing the gaseous hydrocarbon yields for the pyrolysis of LDPE. Using the H-ZSM-11 catalyst in the pyrolysis of LDPE greatly enhanced the content of propylene in the pyrolytic gas because of promoted dehydrogenation of propane formed during the pyrolysis. Apart from the light aliphatic hydrocarbons, jet fuel-, diesel-, and motor oil-range hydrocarbons were found in the pyrolytic liquid for the non-catalytic and catalytic pyrolysis. The change in pyrolysis temperature for the catalytic pyrolysis affected the hydrocarbon compositions of the pyrolytic liquid more materially than for the non-catalytic pyrolysis. This study experimentally showed that H-ZSM-11 can be effective at producing fuel-range hydrocarbons from LDPE waste through pyrolysis. The results would contribute to the development of waste valorization process via plastic upcycling.

Achievements in pyrolysis process in E-waste management sector

Many aspects of modern life of our civilization are associated with using electrical and electronic devices (EEE). Ever-increasing demand for high-performance EEE and accelerated technological development make the replacement of EEE become frequent. This leads to the generation of a tremendous amount of electronic waste (E-waste). Challenges of the management of E-waste have recently arisen out of a dearth of proper technologies to treat E-waste. Pyrolysis process can thermochemically treat waste materials that have a complicated nature and inhomogeneity. This article gives a systematic review as an effort to tackle the challenges in the context of achievements in pyrolysis process in E-waste management sector. Pyrolysis mechanism and types of pyrolysis processes and pyrolysis reactors are first discussed. Various pyrolysis technologies applied to the E-waste treatment are then summarized and compared to each other. Points to be considered for further research and pending challenges of E-waste pyrolysis are also discussed. The pyrolysis treatment of E-waste is not yet fully industrialized mostly because of high costs. However, there should be much room for further developing the E-waste pyrolysis; hence, its industrialization and commercialization is just a matter of time.

Revealing the exciton fine structure of PbSe nanocrystal quantum dots using optical spectroscopy in high magnetic fields

We measure the photoluminescence lifetime τ of excitons in colloidal PbSe nanocrystals (NCs) at low temperatures to 270 mK and in high magnetic fields to 15 T. For all NCs, τ increases sharply below 10 K but saturates by 500 mK. In contrast to the usual picture of well-separated "bright" and "dark" exciton states (found, e.g., in CdSe NCs), these dynamics fit remarkably well to a system having two exciton states with comparable--but small--oscillator strengths that are separated by only 300-900  μeV depending on NC size. Importantly, magnetic fields reduce τ below 10 K, consistent with field-induced mixing between the two states. Magnetic-circular dichroism studies reveal exciton g factors from 2-5, and magnetophotoluminescence shows >10% circularly polarized emission.