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Lack of causal association between cheese intake and risk of peripheral vascular diseases: A two-sample Mendelian randomization study 奶酪摄入量与外周血管疾病风险之间缺乏因果关系：双样本孟德尔随机研究

Medicine Advances

Pub Date : 2024-03-20 DOI: 10.1002/med4.48

Song Wen, Zehan Huang, Guodong He, Bin Zhang, Yuqing Huang

Background

Previous observational studies have yielded inconclusive findings regarding the potential association between cheese intake and peripheral vascular diseases (PVDs). We sought to systematically investigate the causal link between cheese intake and PVDs.

Methods

A two-sample Mendelian randomization (MR) investigation was undertaken to evaluate the causal link between cheese intake and PVDs. This MR analysis relied on summary statistics derived from published genome-wide associations studies (GWAS). GWAS summary statistics for cheese intake (N = 451,486), peripheral artery disease (PAD) (N = 361,194), PVD (N = 463,010), pulmonary embolism (PE) (N = 463,010), and deep vein thrombosis (DVT) (N = 6795) were derived from the UK Biobank. GWAS summary statistics for peripheral angiopathy (N = 162,394), aortic dissection (N = 218,792), aortic aneurysm (AA) (N = 218,792), other PVDs (N = 218,792), and arterial embolism and thrombosis of lower extremity artery (N = 218,792) were extracted from the FinnGen. Primary analysis was performed using an inverse variance weighted method. Sensitivity analyses included weighted median, MR Egger, and weighted mode analyses. Results are shown as odd ratio (OR) and 95% confidence interval (CI).

Results

Genetically predicted cheese intake was not associated with PAD (OR = 1.00, 95% CI: 1.00–1.00, p = 0.953), PVD (OR = 1.00, 95% CI: 0.99–1.00, p = 0.265), peripheral angiopathy (OR = 0.56, 95% CI: 0.09–3.66, p = 0.566), aortic dissection(OR = 0.69, 95% CI: 0.19–2.55, p = 0.583), AA(OR = 0.92, 95% CI: 0.46–1.82, p = 0.809), other PVDs (OR = 0.99, 95% CI: 0.44–2.21, p = 0.979), PE (OR = 1.00, 95% CI:1.00–1.00, p = 0.635), DVT (OR = 0.83, 95% CI: 0.62–1.12, p = 0.229), and arterial embolism and thrombosis of lower extremity artery (OR = 0.69, 95% CI: 0.21–2.29, p = 0.5413).

Conclusion

Based on the results of our two-sample MR analysis, we found no significant association between cheese intake and the risk of PVDs. We firmly believed that these findings had the potential to enhance the efficacy of prevention strategies for PVDs, at both the national and clinical level, by improving our understanding of the risk factors involved in their development. Low-sugar, low-salt and low-fat cheese may be a good choice for people at high risk of PVDs.

以往的观察性研究对奶酪摄入量与外周血管疾病（PVDs）之间的潜在联系没有得出结论。为了评估奶酪摄入量与心血管疾病之间的因果关系，我们进行了一次双样本孟德尔随机化（MR）调查。这项MR分析依赖于从已发表的全基因组关联研究（GWAS）中得出的汇总统计数据。奶酪摄入量（N = 451,486 ）、外周动脉疾病（PAD）（N = 361,194 ）、心血管疾病（PVD）（N = 463,010 ）、肺栓塞（PE）（N = 463,010 ）和深静脉血栓形成（DVT）（N = 6795 ）的 GWAS 概要统计数据来自英国生物库。外周血管病（162,394 人）、主动脉夹层（218,792 人）、主动脉瘤（AA）（218,792 人）、其他心血管内皮病变（218,792 人）以及下肢动脉栓塞和血栓形成（218,792 人）的 GWAS 概要统计数据来自 FinnGen。主要分析采用反方差加权法。敏感性分析包括加权中位数、MR Egger 和加权模式分析。结果显示为奇数比（OR）和 95% 置信区间（CI）。基因预测的奶酪摄入量与 PAD（OR = 1.00，95% CI：1.00-1.00，p = 0.953）、PVD（OR = 1.00，95% CI：0.99-1.00，P = 0.265）、外周血管病（OR = 0.56，95% CI：0.09-3.66，P = 0.566）、主动脉夹层（OR = 0.69，95% CI：0.19-2.55，P = 0.583）、AA（OR = 0.92，95% CI：0.46-1.82，P = 0.809）、其他 PVDs（OR = 0.99，95% CI：0.44-2.21，P = 0.979）、PE（OR = 1.00，95% CI：1.00-1.00，P = 0.635）、DVT（OR = 0.83，95% CI：0.62-1.12，P = 0.229）和下肢动脉栓塞和血栓形成（OR = 0.根据我们的双样本 MR 分析结果，我们发现奶酪摄入量与心血管疾病风险之间没有显著关联。我们坚信，通过进一步了解心血管疾病发生的风险因素，这些发现有可能在国家和临床层面提高心血管疾病预防策略的有效性。低糖、低盐和低脂奶酪可能是心血管疾病高危人群的不错选择。

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引用次数: 0

Quality of life, adherence and knowledge of epileptic patients and the impact of a pharmacist-led educational intervention: A review 癫痫患者的生活质量、依从性和知识以及药剂师主导的教育干预措施的影响：综述

Medicine Advances

Pub Date : 2024-03-19 DOI: 10.1002/med4.55

Zahraa Abbas Munaf, Samer Imad Mohammed

Around 65 million individuals suffer from epilepsy worldwide, and when it is not properly treated, it is linked to higher rates of physical harm and mortality. Due to the requirement for long-term therapy and the side effects of many medications, medication compliance is a significant issue. The purpose of this review was to summarize the findings of previous studies examining the quality of life (QOL), adherence, patient education, and medication knowledge, as well as the impact of a pharmacist-led educational intervention. Additionally, to find out if these studies benefit epileptic patients, to find the appropriate method used to help them in all aspects of their lives, and to use these in future studies. A systematic and comprehensive search was conducted using specific keywords from PubMed, Google Scholar, and Research Gate. A significantly poorer QOL was linked to prolonged antiepileptic drug use or poor adherence as well as psychiatric problems. Neglect was the most frequent reason for nonadherence. The frequency of seizures was greatly reduced, and the adherence was significantly increased by patient education and medication understanding. Patient awareness, adherence, QOL, and seizure frequency were dramatically improved following the intervention. In the absence of optimal treatment, epilepsy is associated with increased rates of bodily injuries and mortality. It is crucial to increase patient education and knowledge about disease and treatment in order to improve adherence, and QOL. Intervention by a chemist is required to achieve these results.

全世界约有 6500 万人患有癫痫，如果治疗不当，会导致更高的身体伤害率和死亡率。由于需要长期治疗以及许多药物的副作用，服药依从性是一个重要问题。本综述旨在总结以往研究的结果，包括生活质量（QOL）、依从性、患者教育和药物知识，以及药剂师主导的教育干预措施的影响。此外，还想了解这些研究是否有益于癫痫患者，找到在生活的各个方面帮助他们的适当方法，并将其用于未来的研究中。我们使用 PubMed、Google Scholar 和 Research Gate 中的特定关键词进行了系统而全面的搜索。患者的生活质量明显较差与长期服用抗癫痫药物或依从性差以及精神问题有关。忽视是不坚持用药的最常见原因。通过对患者的教育和对药物的了解，癫痫发作的频率大大降低，依从性显著提高。干预后，患者的认知度、依从性、生活质量和癫痫发作频率都得到了显著改善。在缺乏最佳治疗的情况下，癫痫会增加身体伤害和死亡率。加强对患者的教育，提高他们对疾病和治疗的认识，对于改善患者的依从性和生活质量至关重要。要取得这些成果，需要化学家进行干预。

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引用次数: 0

Scoring system related to retrograde percutaneous coronary intervention for coronary chronic total occlusion 逆行经皮冠状动脉介入治疗冠状动脉慢性全闭塞的相关评分系统

Medicine Advances

Pub Date : 2024-03-19 DOI: 10.1002/med4.54

Song Wen, Jing Wang, Zehan Huang, Yuqing Huang, Feng Wang, Bin Zhang

The retrograde approach is a principal procedure used in coronary chronic total occlusion percutaneous coronary intervention. However, the retrograde approach presents more challenges compared with the antegrade approach, as it is associated with a lower rate of success and a higher risk of complications. An accurate pre-procedural evaluation of the complexity of a lesion could aid in the planning of the procedure, in estimating the procedure's duration, or in determining whether the patient should be referred to another center specializing in CTO-PCI, as well as in a more precise evaluation of the risk-benefit ratio. In recent years, multiple scoring systems have been created to forecast the success and efficiency of the retrograde procedure. However, each scoring system was developed independently, and comparative studies were lacking. This article provides a review of these scoring systems, offers an overview of the current state of the retrograde approach, and aims to stimulate further discussion on this topic.

逆行入路是冠状动脉慢性全闭塞经皮冠状动脉介入治疗的主要方法。然而，逆行入路与顺行入路相比面临更多挑战，因为逆行入路的成功率较低，并发症风险较高。术前对病变复杂程度的准确评估有助于制定手术计划、估算手术时间或决定是否应将患者转至另一家专门从事 CTO-PCI 的中心，也有助于更精确地评估风险收益比。近年来，已有多种评分系统用于预测逆行手术的成功率和效率。然而，每种评分系统都是独立开发的，缺乏比较研究。本文对这些评分系统进行了综述，概述了逆行手术的现状，并旨在激发对这一话题的进一步讨论。

引用次数: 0

Coffee and caffeine consumption and risk of periodontitis: National Health and Nutrition Examination Survey 2009–2014 咖啡和咖啡因摄入量与牙周炎风险：2009-2014年全国健康与营养调查

Medicine Advances

Pub Date : 2024-03-08 DOI: 10.1002/med4.50

Wan-Zhe Liao, Zhi-Yi Zhou, Xian-Nan Wu, Xiao-Feng Zhu, Song-An Li, Jun-Huang Zheng, Jia-Nuo Tan, Hao-Kai Chen, Ting-Yu Gu, Zhe Xu, Ya-Han Li, Xu-Guang Guo

Background

This study aimed to evaluate whether coffee consumption and caffeine intake are independently associated with periodontitis infection.

Methods

Coffee consumption was categorized into binary and continuous variables, serving as the exposure factor alongside caffeine intake, with periodontitis infection as the outcome variable. Other covariables were regarded as potential confounders. The cross-sectional study was conducted based on the national health and nutrition examination survey, with multivariate regression models, subgroup analyses, smooth fitting curves, and threshold effect examinations conducted to pursue a definite correlation between exposures and the outcome.

Results

Negative associations were discovered between binary coffee consumption (OR = 0.81, 95% CI = (0.71, 0.92), p-value = 0.001) and caffeine intake (Q3: OR = 0.77, 95% CI = (0.66, 0.91), p-value = 0.002; Q4: OR = 0.76, 95% CI = (0.64, 0.90), p-value = 0.001) with periodontitis infection, respectively, with all confounders adjusted. In subgroup analyses stratified by gender, diabetes mellitus status, and hypertension status, interaction, and threshold effects were observed, which were intuitively revealed by smooth-fitting curves.

Conclusions

Significant negative associations between binary consumption and caffeine intake and periodontitis infection separately were indicated, with no evidence suggesting a credible correlation between continuous coffee consumption and infection risk of periodontitis. The benefits of the behavior of consuming coffee and caffeine were more obvious among males and individuals who did not suffer from diabetes or hypertension.

本研究旨在评估咖啡饮用量和咖啡因摄入量是否与牙周炎感染独立相关。咖啡饮用量分为二元变量和连续变量，与咖啡因摄入量一起作为暴露因素，牙周炎感染作为结果变量。其他协变量被视为潜在的混杂因素。这项横断面研究以全国健康与营养状况调查为基础，通过多变量回归模型、亚组分析、平滑拟合曲线和阈值效应检验来寻求暴露因素与结果之间的明确相关性。发现二元咖啡饮用量（OR = 0.81，95% CI = (0.71，0.92)，p 值 = 0.001）和咖啡因摄入量（Q3：OR = 0.77，95% CI = (0.66，0.91)，p 值 = 0.002；Q4：OR = 0.76，95% CI = (0.66，0.91)，p 值 = 0.002）之间存在负相关：在调整了所有混杂因素后，牙周炎感染的OR = 0.76，95% CI = (0.64，0.90)，p值 = 0.001。在按性别、糖尿病状态和高血压状态分层的亚组分析中，观察到了交互作用和阈值效应，这些效应通过平滑拟合曲线直观地显示出来。二元消费和咖啡因摄入量分别与牙周炎感染之间存在显著的负相关，没有证据表明连续饮用咖啡与牙周炎感染风险之间存在可信的相关性。饮用咖啡和咖啡因的行为对男性和未患糖尿病或高血压者的益处更为明显。

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引用次数: 0

Modifying the electrical, optical, and magnetic properties of cancer cells: A comprehensive approach for cancer management 改变癌细胞的电学、光学和磁学特性：癌症管理的综合方法

Medicine Advances

Pub Date : 2024-03-08 DOI: 10.1002/med4.51

Rishav Sharma, Rishabha Malviya

Despite the recent successes of cancer therapy, numerous obstacles remain. The medical community of the 16^th century believed that magnets might be used to cure or prevent illness. However, this concept has only recently been put into practice in the treatment of cancer. Cancers vary greatly not only at the patient, tissue, and cellular levels but also at the molecular level. Because of this multiscale heterogeneity, effective treatments that not only differentiate between cancerous and healthy tissues but also target a wide variety of tumor subclones are difficult to develop. Most treatments either take advantage of a specific biological characteristic shared by cancer cells (e.g., their propensity for rapid division) or indiscriminately eradicate every cell in an area of interest. In this article, we review the physical, chemical, electrical, optical, and magnetic properties of cancer cells, before discussing how these properties may be modulated by current and future cancer therapies.

尽管近年来癌症治疗取得了巨大成功，但仍然存在许多障碍。16 世纪的医学界认为，磁铁可以用来治疗或预防疾病。然而，这一理念直到最近才在癌症治疗中付诸实践。癌症不仅在患者、组织和细胞层面存在巨大差异，在分子层面也是如此。由于这种多尺度的异质性，很难开发出既能区分癌症组织和健康组织，又能针对各种肿瘤亚克隆的有效治疗方法。大多数治疗方法要么是利用癌细胞共有的特定生物特性（如快速分裂倾向），要么是不加区别地消灭相关区域的所有细胞。在本文中，我们将回顾癌细胞的物理、化学、电学、光学和磁学特性，然后讨论如何通过当前和未来的癌症疗法来调节这些特性。

引用次数: 0

Salamanders aid research into mechanisms of non-canonical organ regeneration for clinical applications 蝾螈有助于研究临床应用中的非典型器官再生机制

Medicine Advances

Pub Date : 2024-03-05 DOI: 10.1002/med4.49

Binxu Yin, Xiao Cui, Yanmei Liu, Ji-Feng Fei

Salamanders possess remarkable regenerative capacities for organ regeneration among tetrapod vertebrates. Previous research has primarily focused on studying the regeneration of canonical tissues or organs such as limbs, tail, brain, spinal cord, heart, and lens. The advancements made in these areas have broader implications for understanding regeneration and developing therapeutic approaches for these organs, not only in salamanders but also in other vertebrates. In recent years, there has been an increasing interest in studying the regeneration of non-canonical organs in salamanders, such as the liver, lungs, kidneys, and pancreas. This diversification of research has opened up new avenues and provided potential solutions to challenging clinical problems. This review aims to summarize the progress made in the field of non-canonical organ regeneration in salamanders and provides an outlook on future research directions.

在四足脊椎动物中，蝾螈具有非凡的器官再生能力。以往的研究主要集中在研究四肢、尾部、大脑、脊髓、心脏和晶状体等典型组织或器官的再生。这些领域取得的进展不仅对蝾螈，而且对其他脊椎动物了解这些器官的再生和开发治疗方法具有广泛的意义。近年来，人们对研究蝾螈非典型器官（如肝脏、肺脏、肾脏和胰腺）的再生越来越感兴趣。这种多样化的研究开辟了新的途径，并为具有挑战性的临床问题提供了潜在的解决方案。本综述旨在总结蝾螈非典型器官再生领域所取得的进展，并展望未来的研究方向。

引用次数: 0

Bullous pemphigoid is a rare autoimmune skin disease that affects the scalp: A case report 大疱性类天疱疮是一种影响头皮的罕见自身免疫性皮肤病：病例报告

Medicine Advances

Pub Date : 2024-03-03 DOI: 10.1002/med4.47

Salkapuram Sunil Kumar, Karthikeyan Elumalai, Navaneetha Krishnan Subramaniyan, Srinivasan Sivannan, Sivaneswari Srinivasan

Pemphigoid, a rare autoimmune skin disease affecting the elderly, requires effective pharmacy management. This includes medication therapy, patient education, and counseling. Understanding pharmacokinetics and potential drug interactions are crucial for optimal treatment and minimizing adverse effects. In this case, the patient is a 65-year-old male who was diagnosed with pemphigoid 2 months ago. He is currently taking prednisone, an oral corticosteroid, to manage the symptoms. The pharmacist plays a crucial role in medication therapy by monitoring the patient's response to the medication and adjusting the dosage if necessary. Additionally, patient education is vital in ensuring that the patient understands the importance of adherence to the medication regimen and the potential side effects. The pharmacist can also provide counseling on lifestyle modifications and self-care measures to alleviate symptoms and improve the quality of life. Overall, effective pharmacy management is essential for optimizing treatment outcomes and promoting patient well-being in pemphigoid cases. The pharmacist's role in pemphigoid cases is crucial for effective medication management and patient education. They monitor the patient's response to treatment, make necessary adjustments, and empower them to take an active role in managing their condition. This approach ultimately improves the overall well-being of patients with pemphigoid.

丘疹性荨麻疹是一种影响老年人的罕见自身免疫性皮肤病，需要有效的药房管理。这包括药物治疗、患者教育和咨询。了解药代动力学和潜在的药物相互作用对于优化治疗和减少不良反应至关重要。在本病例中，患者是一名 65 岁的男性，2 个月前被诊断出患有丘疹性荨麻疹。他目前正在服用泼尼松（一种口服皮质类固醇）来控制症状。药剂师在药物治疗中发挥着至关重要的作用，他们负责监测患者对药物的反应，并在必要时调整剂量。此外，患者教育对于确保患者了解坚持用药的重要性和潜在的副作用也至关重要。药剂师还可以提供生活方式调整和自我护理措施方面的咨询，以减轻症状并提高生活质量。总之，有效的药房管理对于优化治疗效果和促进丘疹性荨麻疹患者的健康至关重要。药剂师在丘疹性荨麻疹病例中的作用对于有效的药物管理和患者教育至关重要。他们会监测患者对治疗的反应，做出必要的调整，并让患者在控制病情方面发挥积极作用。这种方法最终会改善丘疹性荨麻疹患者的整体健康。

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引用次数: 0

Medical Advances keeps track of new developments on the frontiers of medicine: The 1st founding anniversary of the Medical Advances 医学进展》跟踪医学前沿的新发展：医学进展》创刊一周年

Medicine Advances

Pub Date : 2024-02-29 DOI: 10.1002/med4.52

Xueqing Yu

Medicine Advances is a platform dedicated to sharing cutting-edge research, insights, and advancements in the field of medicine. As the Editor-in-Chief, it is my privilege to guide this journal towards its mission of promoting knowledge, innovation, and excellence in healthcare.

The aim of Medicine Advances is to provide a platform for researcher, scholars, and practitioners in healthcare to communicate and share their scientific findings and innovations. The journal is committed to promoting new medical theories, exchanging new clinical technologies, presenting new medical products, and accelerating the pace of medical development. This journal is dedicated to publishing high-quality original research articles, review articles, survey articles, case reports, editorials, and short communications.

In 2023, we successfully launched the Medicine Advances and published 4 issues containing 37 high-quality articles. Among the published papers, the majority were original articles (19), accounting for 51%, followed by “review” and “case report” (8 and 2, respectively). Among these submissions, the proportion of Chinese authors is the highest (58%). But the manuscripts from India, Egypt, and the United States accounted for 32%.

We have successfully established a WeChat public account in China, enhancing our accessibility and outreach. A total of 37 WeChat public account articles were published, and the articles and the journal received effective publicity. At the same time, we also promote on some international social media sites, like Twitter, Linkedin and ResearchGate.

The continued publicity resulted in good downloads and citations. Our articles' readership and download rates have shown a consistent upward trend, which is a testament to our collective efforts. Together, these articles have amassed over 12,000 downloads and 5 citations.

The involvement of 87 globally renowned experts in various medical specialties as our editorial members has significantly elevated our influence abroad. Seventeen of the 37 articles were from the journal's editorial board. The editorial board has made great contributions to the development of the journal.

The enthusiastic reception of our special issues, “Application of Omics in Diseases” and “CardioRenal Research,” inspires us to delve even deeper into these critical fields, evidence of our journal's synergy with the scientific community's pulse.

The journal's progress has grown substantially since its inception. I would like to express my heartfelt gratitude to our authors, reviewers, and readers for their continuous support and dedication. Thank you for being a part of our journey. Your contributions are what make our journal thrive and evolve. Together, we can shape the future of medicine and healthcare, making a positive impact on the lives of millions.

Xueqing Yu: Conceptualization; writing original draft; review; editing.

The auth

医学进展》是一个致力于分享医学领域前沿研究、见解和进展的平台。作为主编，我很荣幸能指导该杂志实现其使命，即促进医疗保健领域的知识、创新和卓越。《医学进展》的宗旨是为医疗保健领域的研究人员、学者和从业人员提供一个交流和分享其科学发现和创新的平台。本刊致力于推广医学新理论，交流临床新技术，展示医疗新产品，加快医学发展步伐。本刊致力于发表高质量的原创研究文章、综述文章、调查文章、病例报告、社论和短篇通讯。2023年，我们成功创办了《医学进展》，并出版了4期，收录了37篇高质量的文章。在发表的论文中，原创文章占大多数（19 篇），占 51%，其次是 "综述 "和 "病例报告"（分别为 8 篇和 2 篇）。在这些来稿中，中国作者所占比例最高（58%）。我们在中国成功建立了微信公众账号，增强了我们的可及性和外联性。我们在中国成功建立了微信公众账号，增强了我们的可及性和外联性，共发布了 37 篇微信公众账号文章，文章和期刊得到了有效宣传。同时，我们还在 Twitter、Linkedin 和 ResearchGate 等国际社交媒体网站上进行宣传。我们文章的阅读率和下载率呈持续上升趋势，这是对我们集体努力的最好证明。87位全球知名的各医学专业专家担任我们的编辑成员，大大提升了我们在国外的影响力。在 37 篇文章中，有 17 篇来自期刊编辑部。我们的特刊 "奥米克在疾病中的应用 "和 "心肾研究 "受到了热烈欢迎，这激励着我们在这些关键领域进行更深入的研究，这也证明了我们的期刊与科学界的脉搏形成了合力。在此，我衷心感谢我们的作者、审稿人和读者一直以来的支持和奉献。感谢您参与我们的旅程。是你们的贡献让我们的期刊蓬勃发展。我们可以共同塑造医学和医疗保健的未来，为数百万人的生活带来积极影响：构思；撰写原稿；审稿；编辑。作者声明无利益冲突。

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引用次数: 0

IV ketamine infusion therapy for chronic pain: A systematic review and meta-analysis 静脉注射氯胺酮治疗慢性疼痛：系统回顾和荟萃分析

Medicine Advances

Pub Date : 2023-12-19 DOI: 10.1002/med4.45

Peter Olujimi Odutola, Ruchir Gupta

Background

Chronic pain exerts a significant physical, emotional, and socioeconomic toll on millions of patients worldwide. Traditional pharmacological interventions are often inadequate in providing lasting and effective pain relief for patients suffering from severe chronic pain. However, in recent years, intravenous ketamine infusion therapy has emerged as a promising and alternative treatment modality. The effectiveness of intravenous ketamine infusion therapy in treating chronic pain has been investigated in various pain conditions, such as neuropathic pain, fibromyalgia, complex regional pain syndrome (CRPS), and phantom limb pain. However, varied patient demographics, different endpoints for measuring analgesia, and inconsistent numbers of patients in studies have led to conflicting results. The objective of the present inquiry is to undertake a contemporary updated meta-analysis of the application of IV ketamine infusion therapy in the context of persistent pain.

Methods

A search was conducted, adhering to the PRISMA guidelines, to compare the efficacy of IV Ketamine infusion versus control (placebo, midazolam, gabapentin, hydromorphone, and pregabalin) among individuals with chronic pain. During the analysis, Medline, Cochrane, and Embase were thoroughly searched. Two independent investigators identified randomized double-blind and non-randomized trials comparing IV Ketamine infusions with controls. Review Manager 5.4.1 was used to scrutinize the data, with the main focus on pain scores. Secondary outcomes such as quality of sleep, as well as side effects such as nausea, hallucinations, and sedation, were also analyzed. Sixteen studies were included involving 1080 patients.

Results

The pain score was significantly reduced by IV Ketamine (Mean difference −1.05; 95% CI −1.72, −0.39; p = 0.002), while the quality of sleep (Mean difference 0.00; 95% CI −0.12, 0.12; p = 1.00) was not significantly different between studies. Nausea (risk ratio 1.42; 95% CI 0.84, 2.39; p = 0.19), hallucinations (risk ratio 1.08; 95% CI 0.67, 1.76; p = 0.75), and sedation (risk ratio 1.05; 95% CI 0.24, 4.54; p = 0.95) outcomes were not significantly different among the studies.

Conclusions

Our meta-analysis indicates that IV Ketamine infusion is efficacious and safe in patients with chronic pain.

慢性疼痛给全球数百万患者的身体、情感和社会经济造成了巨大损失。传统的药物干预往往不足以为严重慢性疼痛患者提供持久有效的镇痛效果。然而，近年来，氯胺酮静脉输注疗法已成为一种前景广阔的替代治疗方式。氯胺酮静脉输注疗法治疗慢性疼痛的有效性已在神经病理性疼痛、纤维肌痛、复杂区域疼痛综合征（CRPS）和幻肢痛等多种疼痛病症中进行了研究。然而，不同的患者人口统计学特征、不同的镇痛测量终点以及研究中不一致的患者人数导致了相互矛盾的结果。本研究旨在对氯胺酮静脉输注疗法在顽固性疼痛中的应用进行最新的荟萃分析。研究人员按照 PRISMA 指南进行了检索，以比较氯胺酮静脉输注与对照组（安慰剂、咪达唑仑、加巴喷丁、氢吗啡酮和普瑞巴林）在慢性疼痛患者中的疗效。在分析过程中，对 Medline、Cochrane 和 Embase 进行了全面检索。两名独立研究人员确定了比较静脉注射氯胺酮与对照组的随机双盲和非随机试验。使用Review Manager 5.4.1对数据进行了仔细检查，主要关注疼痛评分。此外，还分析了睡眠质量等次要结果以及恶心、幻觉和镇静等副作用。静脉注射氯胺酮可显著降低疼痛评分（平均差异-1.05；95% CI -1.72, -0.39；p = 0.002），而睡眠质量（平均差异0.00；95% CI -0.12, 0.12；p = 1.00）在不同研究中无显著差异。恶心（风险比 1.42；95% CI 0.84，2.39；p = 0.19）、幻觉（风险比 1.08；95% CI 0.67，1.76；p = 0.75）和镇静（风险比 1.05；95% CI 0.24，4.54；p = 0.95）的结果在各研究间无明显差异。

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引用次数: 0

From consumption to withdrawal: A broad synopsis of the effects of alcohol 从饮酒到戒酒：酒精影响概述

Medicine Advances

Pub Date : 2023-12-18 DOI: 10.1002/med4.46

Jun Zhu, Qi Liu, Bin Kong, Wei Shuai, Zheng Xiao, Chang Dai, He Huang

The consumption of alcohol reflects both societal norms and personal choices and has major clinical implications. Long-term excess alcohol consumption leads to a domino effect of pathological outcomes and onset of chronic illness. However, the risks of alcohol consumption extend beyond long-term health issues. Because habitual alcohol drinkers reach a state of systemic homeostasis, when they attempt withdrawal, they experience many negative physiological effects and may develop alcohol withdrawal syndrome. The complex interplay between alcohol consumption and withdrawal does not result solely in behavioral issues. Rather, a substantial number of important physiological adaptations and potential problems underly habitual drinking. Addressing these issues requires comprehensive medical observation and intervention. Here, we summarize the pathophysiological mechanisms, clinical diseases, and related treatment methods of alcohol consumption and withdrawal. The aim was to provide a reference to improve understanding of alcohol use and promote an informed approach to alcohol withdrawal.

饮酒既反映了社会规范，也反映了个人选择，对临床有重大影响。长期过量饮酒会引发多米诺骨牌效应，导致病理结果和慢性疾病的发生。然而，饮酒的风险并不局限于长期的健康问题。由于习惯性饮酒者已达到全身平衡状态，当他们试图戒酒时，会经历许多负面的生理影响，并可能患上酒精戒断综合症。饮酒和戒酒之间复杂的相互作用并不仅仅导致行为问题。相反，大量重要的生理适应和潜在问题是习惯性饮酒的基础。解决这些问题需要全面的医学观察和干预。在此，我们总结了饮酒和戒酒的病理生理机制、临床疾病和相关治疗方法。目的是提供一个参考，以增进对饮酒的理解，促进对戒酒的知情。

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