Medical Gas Research最新文献

Fournier's gangrene is a rare, rapidly progressive necrotizing soft tissue infection of the genitals and perineum that continues to carry a high mortality rate. Hyperbaric oxygen therapy has been proposed as an adjunctive treatment, but its efficacy remains uncertain. We conducted a systematic review and meta-analysis of studies comparing hyperbaric oxygen therapy with standard care in adults with Fournier's gangrene. A comprehensive search of PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science identified thirteen retrospective studies including 322 patients treated with hyperbaric oxygen therapy and 366 controls. Hyperbaric oxygen therapy was associated with a significantly lower mortality rate compared with control groups. Secondary outcomes, including hospital length of stay and number of debridements, showed inconsistent results and did not differ significantly between groups. These findings suggest that hyperbaric oxygen therapy may reduce mortality in patients with Fournier's gangrene and could be considered as an adjunctive therapy. FactsA meta-analysis demonstrated hyperbaric oxygen therapy reduces the relative risk of death in patients suffering from Fournier's gangrene.The present study has revealed no statistically significant differences in terms of hospital length of stay or the number of surgical debridements in patients with Fournier's gangrene between the hyperbaric oxygen therapy and control groups.The extant evidence supports the use of hyperbaric oxygen therapy as an ancillary measure of Fournier's gangrene following prompt surgical debridement and antimicrobial therapy, rather than as a primary treatment modality.Open questionsWhat are the optimal hyperbaric oxygen treatment protocols (pressure, duration, number of sessions) for patients with Fournier's gangrene?Which patient subgroups (e.g. comorbidities, infection severity) derive the most benefit from hyperbaric oxygen therapy?How does hyperbaric oxygen therapy affect resource utilization and cost-effectiveness, particularly in healthcare systems with limited hyperbaric infrastructure?

Vascular dementia is a highly heterogeneous neurodegenerative disorder induced by a variety of factors. Currently, there are no definitive treatments for the cognitive dysfunction associated with vascular dementia. However, early detection and preventive measures have proven effective in reducing the risk of onset and improving patient prognosis. Nitric oxide plays an integral role in various physiological and pathological processes within the central nervous system. In recent years, nitric oxide has been implicated in the regulation of synaptic plasticity and has emerged as a crucial factor in the pathophysiology of vascular dementia. At different stages of vascular dementia, nitric oxide levels and bioavailability undergo dynamic alterations, with a marked reduction in the later stages, which significantly contributes to the cognitive deficits associated with the disease. This review provides a comprehensive review of the emerging role of nitric oxide in the physiological and pathological processes underlying vascular dementia, focusing on its effects on synaptic dysfunction, neuroinflammation, oxidative stress, and blood‒brain barrier integrity. Furthermore, we suggest that targeting the nitric oxide soluble guanylate cyclase-cyclic guanosine monophosphate pathway through specific therapeutic strategies may offer a novel approach for treating vascular dementia, potentially improving both cognitive function and patient prognosis. The review contributes to a better understanding of the multifaceted role of nitric oxide in vascular dementia and to offering insights into future therapeutic interventions.

Hyperbaric oxygen therapy has emerged as a potential adjunctive treatment for male infertility, as it targets various sperm abnormalities and improves fertility outcomes. This systematic review and meta-analysis synthesized data from randomized controlled trials to evaluate the efficacy of hyperbaric oxygen therapy in treating male infertility. A comprehensive literature search identified nine eligible studies, which were assessed for quality using the Jadad scale and analyzed for heterogeneity. The meta-analysis revealed significant improvements in sperm survival, density, morphology, normal sperm rates, and motility following hyperbaric oxygen therapy, with an increased clinical pregnancy rate. Subgroup analyses based on infertility etiology and treatment duration further elucidated the heterogeneity of male infertility stemming from the etiology of infertility. Despite the high robustness of the meta-analysis results, the study is limited by the small number of included trials and potential publication bias. In conclusion, when combined with conventional treatments, hyperbaric oxygen therapy significantly enhances sperm parameters and fertility, underscoring its role as an effective adjunctive therapy for male infertility.

Numerous physiological processes in the human skin are mediated by nitric oxide, a gaseous signalling molecule. Almost every type of skin cell may produce nitric oxide, it is possible to generate nitric oxide without the need of enzymes. Nitric oxide plays a crucial role in regulating apoptosis, keratinocyte differentiation and proliferation, the protective properties of the epidermal barrier, and the structure and functions of the microcirculatory bed. Nitric oxide is involved in immunological and inflammatory responses, hair growth regulation, and wound healing processes. It mediates ultraviolet-induced processes such as erythema and edema development and participates in melanogenesis. Furthermore, the ability of nitric oxide to bind reactive oxygen species and prevent lipid peroxidation gives it antioxidant qualities. This coordinated action of nitric oxide on gene expression and membrane integrity effectively protects cells from ultraviolet A-induced apoptosis and necrosis. Furthermore, nitric oxide can be considered as a molecule that inhibits the development of cancer and photoaging. It directly harms microorganisms and indirectly activates the immune system, exhibiting antibacterial, antiviral, and antifungal qualities. Notably, nitric oxide is effective against antibiotics-resistant bacteria. All of the aforementioned findings suggest that nitric oxide is a gaseous mediator that can protect skin function.

Controlling or eliminating N-nitrosamine impurities in pharmaceutical products has become a significant challenge for both drug manufacturers and regulatory authorities. This difficulty is particularly pronounced in light of the recent increase in nitrosamine drug substance-related impurities, which have raised concerns about the safety and efficacy of various medications. Additionally, the pharmaceutical industry faces the challenge of developing analytical methods that are not only sensitive and selective but also precise and accurate. These methods are crucial for the reliable quantification of low levels of N-nitrosamine impurities, ensuring compliance with stringent current regulatory guidelines. The intricate nature of detecting these impurities at such low levels necessitates the use of cutting-edge analytical techniques, such as liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry. In light of these challenges, this review article explores the latest regulatory guidelines and analytical methodologies concerning N-nitrosamine impurities in various pharmaceutical products for 2024. Findings from this review article help provide valuable insights for researchers and industry professionals to enhance the safety and quality of pharmaceutical products.

Acute carbon monoxide poisoning-induced myocardial injury is easily overlooked. However, patients with acute carbon monoxide poisoning, especially older adult patients, often have difficulty expressing clinical symptoms due to early consciousness disturbances, making the early identification of complications challenging and leading to delayed diagnosis and treatment. Therefore, exploring indicators that can predict in-hospital cardiovascular adverse events in older adult patients with acute carbon monoxide poisoning -induced myocardial injury has important clinical significance. Therefore, this retrospective cross-sectional study included older adult patients with acute carbon monoxide poisoning-induced myocardial injury at the Department of Hyperbaric Oxygen of Beijing Chao-Yang Hospital from January 2013 to December 2019. A total of 119 older adult patients with acute carbon monoxide poisoning-induced myocardial injury were included in the study, with 94 patients in the nonevent group (54 males, 40 females, 71.09 ± 7.60 years) and 25 patients in the cardiovascular adverse event group (10 males, 15 females, 71.48 ± 10.38 years). Compared with those in the nonevent group, creatine kinase isoenzyme levels, triglyceride levels, the neutrophil/lymphocyte ratio and the monocyte/high-density lipoprotein cholesterol ratio were significantly greater in the cardiovascular adverse event group, and high-density lipoprotein cholesterol levels were significantly lower in the cardiovascular adverse event group. Further binary logistic regression analysis showed that higher monocyte/high-density lipoprotein cholesterol ratio might be an independent risk factor for in-hospital adverse events in older adult patients with acute carbon monoxide poisoning-induced myocardial injury (OR = 109.783, 95% CI: 2.644-4557.834; P = 0.013). The area under the curve of the monocyte/high-density lipoprotein cholesterol ratio in predicting in-hospital cardiovascular adverse events in older adult patients with myocardial injury due to acute carbon monoxide poisoning was 0.797, the cutoff value was 0.645, the sensitivity was 68.0%, and the specificity was 88.2%. The inflammatory indicators monocyte/high-density lipoprotein cholesterol ratio and neutrophil/lymphocyte ratio were identified as an independent risk factor for predicting in-hospital cardiovascular adverse events in older adult patients with acute carbon monoxide poisoning-induced myocardial injury in this study. Specifically, monocyte/high-density lipoprotein cholesterol ratio was identified as an independent risk factor for predicting adverse events during hospitalization.