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Although morphine is the standard opioid analgesic for pain control and has been widely used, certain drug-induced adverse effects have been reported as intolerable and need to be addressed. Nalbuphine may have a few advantages over morphine in this respect. We aimed to describe the effect of nalbuphine as well as its saftey compared to morphine by analyzing published randomized controlled trials (RCTs) with meta-analysis approach. We analysed 15 trials (820 patients). Overall, there was no evidence to show that the effect of pain relief had any difference between nalbuphine and morphine (pooled relative risks [RRs], 1.01; 95% CI, 0.91 to 1.11; P = 0.90). On the other hand, the incidences of pruritus, nausea, vomiting, respiratory depression were significantly lower in nalbuphine group compared with morphine group, and the pooled RRs were 0.78(95%CI, 0.602–0.997; P = 0.048) for nausea, 0.65(95%CI, 0.50–0.85; P = 0.001) for vomiting, 0.17(95%CI, 0.09–0.34; P < 0.0001) for pruritus, and 0.27(95%CI, 0.12–0.57; P = 0.0007) for respiratory depression. The analgesic efficacy of nalbuphine is comparable to morphine, but nalbuphine provides a better safety profile than morphine in the aspect of certain side-effects, especially related to pruritus and respiratory depression.

PurposeTo study vascular injury following whole thoracic irradiation with single sublethal doses of X-rays in the rat and to develop markers that might predict severity of injury. Materials and MethodsRats after 5 or 10 Gy thorax only irradiation and age-matched controls were studied at 3 days, 2 weeks, 1, 2, 5 and 12 months. Several pulmonary NOT THE PUBLISHED VERSION; this is the author's final, peer-reviewed manuscript. The published version may be accessed by following the link in the citation at the bottom of the page. Oncology -Biology -Physics, Vol. 74, No. 1 (May 2009): pg. 192-199. DOI. This article is © Elsevier and permission has been granted for this version to appear in e-Publications@Marquette. Elsevier does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Elsevier. International Journal of Radiation3 vascular parameters were evaluated, including hemodynamics, vessel density, total lung angiotensin converting enzyme activity and right ventricular hypertrophy. ResultsBy 1 month, rats in the 10 Gy group had pulmonary vascular dropout, right ventricular hypertrophy, increased pulmonary vascular resistance, increased dry lung weights, and decreases in total lung angiotensin converting enzyme activity as well as pulmonary artery distensibility. On the other hand irradiation with 5 Gy resulted only in a modest increase in right ventricular weight and a reduction in lung angiotensin converting enzyme activity. ConclusionsIn a previous investigation employing the same model we observed that there was recovery from radiation induced attenuation of pulmonary vascular reactivity. In this study we report that there is deterioration in several vascular parameters up to 1 year following exposure to 10 Gy suggesting sustained remodeling of the pulmonary vasculature. Our data support clinically relevant injuries which appear in a time and dose related manner after exposure to relatively low doses of radiation.

Following the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), a third, highly pathogenic coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appearing at end of 2019 led to a pandemic, increased panic and attracted global attention. This review analyzes the epidemiology, etiology, clinical characteristics, treatment and sequelae of the severe acute respiratory syndrome (SARS), the Middle East respiratory syndrome (MERS) and the 2019 novel coronavirus disease (COVID-19) to help provide direction for further studies that can help understand COVID-19.