Background: Severe postoperative pain is a significant problem after cesarean sections. Methods: This study was a randomized, controlled trial of 105 patients conducted in two hospitals. All patients were anesthetized spinally for elective cesarean section. Each participant was randomly allocated to one of three study groups: the quadratus lumborum block (QLB) group, the transversus abdominis plane block (TAPB) group, or the control (CON) group. The primary outcome of this study determined acute pain intensity on the visual analog scale (VAS). The secondary outcomes determined morphine consumption and chronic pain evaluation according to the Neuropathic Pain Symptom Inventory (NPSI) after hospital discharge. Results: At rest, the pain intensity was significantly higher in the CON group than in the QLB and TAPB groups at hours two and eight. Upon activity, the pain in the control subjects was more severe than in the QLB and TAPB groups in three and two of five measurements, respectively. Moreover, morphine consumption was significantly lower in the QLB (9 (5–10)) and TAPB (10 (6–14)) groups than in the CON (16 (11–19)) group. Persistent postoperative pain was significantly lower in the QLB group than in the CON group at months one and six following hospital discharge. Conclusions: Both the QLB and TAPB can improve pain management after cesarean delivery. Moreover, the QLB might reduce the severity of persistent postoperative pain months after cesarean section.
The article contains analysis of perspectives of cell technologies use in the therapy of patients with Alzheimer's disease (AD). Currently there are no effective ways to diagnose this disease at early stage. Late diagnostics of AD and weak understanding of its mechanisms complicate clinical tactics leaving in fact palliative (symptomatic) treatment as the only available option. Authors propose a combination of the traditional methods of treatment with newly developed cell therapy technologies. Stem cells (SC) implantation is the basis for recovery of functional activity of neural networks in the regions affected by neurodegeneration. Based upon conducted experimental studies and analysis of scientific literature, the authors recommend to use the technique of the intranasal perineural application of autologous mesenchymal stem cells (MSC) for the treatment of patients with Alzheimer's disease. Following the administration into the submucosa of nasal cavity, SC migrate along the olfactory nerve to the brain promoting a reparative effect, particularly attributed to the excretion of neurotrophic factors (brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), insulin growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF)).
Hypothesis on migration of stem cells to injured brain region after introduction of stem cells into nasolacrimal duct has been experimentally verified on Wistar rats (n=7). Fluorescent stem cells have been detected in the injured region of frontal cerebral cortex using confocal microscopy in 20 hours after implantation of mesenchymal stem cells into nasolacrimal duct of rats.
Chemotherapy is one of the main treatment options for cancer, but it is usually accompanied with negative side effects. The classical drugs combination with synergistic adjuvants can be the solution to this problem, allowing reducing therapeutic dose. Elucidating the mechanism of adjuvant action is of key importance for selection of the optimal agent. Here we examine the system drug-adjuvant to explain observed effect in practice. We used the first line drug – cisplatin. Morpholinium and 4-methylpiperazinium 4,5-dichloro isothiazol-3-carboxylates were selected as adjuvants. The study of cisplatin – adjuvant system was carried out by quantum chemical modeling with DFT method. It turned out that adjuvants form conjugates with cisplatin that leads to relocation of frontier molecular orbitals as well as increase of conjugate’s dipole moment. It results in change of the character of interaction with DNA and increase of bioactivity of system. The data obtained are the basis for expanding the studies to include other drugs and adjuvants. Oncologists will have opportunity to use “classical” chemotherapy drugs in combination with synergists for those patients who have not been previously recommended to such treatment because of pronounced toxic side effects.
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