Acute Disease ; Female ; Humans ; Hypertension ; chemically induced ; Middle Aged ; Organophosphate Poisoning ; Pesticides ; poisoning ; Skin Absorption

Endoscopic treatment for non-variceal upper gastrointestinal bleeding has evolved over decades. Injection with diluted epinephrine is considered as a less than adequate treatment, and the current standard therapy should include second modality if epinephrine injection is used initially. Definitive hemostasis rate following mono-therapy with either thermo-coagulation or hemo-clipping compares favorably with dual therapies. The use of adsorptive powder (Hemo-spray) is a promising treatment although it needs comparative studies between hemospray and other modalities. Stronger hemo-clips with better torque control and wider span are now available. Over-the-scope clips capture a large amount of tissue and may prove useful in refractory bleeding. Experimental treatments include an endoscopic stitch device to over-sew the bleeding lesion and targeted therapy to the sub-serosal bleeding artery as guided by echo-endoscopy. Angiographic embolization of bleeding artery should be considered in chronic ulcers that fail endoscopic treatment especially in elderly patients with a major bleed manifested in hypotension.
Aged ; Arteries ; Endosonography ; Epinephrine ; Hemorrhage ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; Hypotension ; Minerals ; Torque ; Ulcer

OBJECTIVETo analyze the change in nitration tyrosine, NO(2)(-)/NO(3)(-)level in induced sputum of silicosis patients and dust exposure workers and to evaluate the approach and feasibility of nitric oxide (NO) metabolites as early detection indicators of silicosis.

METHODSNitration tyrosine, NO(2)(-)/NO(3)(-)concentration in induced sputum of 80 dust exposure workers, 84 silicosis patients, 30 logistic personnel with no history of exposure to silica dust were determined and the relationship among Nitration tyrosine, NO(2)(-)/NO(3)(-)level and dust exposure years as well as pulmonary function tests were analyzed.

RESULTSNO(2)(-)/NO(3)(-)level among exposed group [60.30 (46.58) micromol/l] was significantly higher than the control group [36.90 (22.28) micromol/l], (P < 0.05), and the level of NO(2)(-)/NO(3)(-)among the cases [79.65 (89.10) micromol/l] was significantly higher than exposed group as well as the control group (P < 0.05). Compared with control, the level of nitration tyrosine in exposed group [3.51 (0.46) nmol/l] and the cases [3.48 (0.49) nmol/l] was significantly higher (P < 0.05). NO(2)(-)/NO(3)(-)level and dust exposure years were positively correlated (r = 0.3733 and 0.3830 respectively P < 0.05); NO(2)(-)/NO(3)(-)level and pulmonary function tests (FVC%, FEV1.0%, PEF%, MEF25%, MEF50%) were negatively correlated (r = 0.1540, 0.1723, 0.1535, 0.1485, 0.1643 respectively, P < 0.05). There was no correlation between nitration tyrosine and dust exposure years (P > 0.05), no correlation between nitration tyrosine and pulmonary function test (P > 0.05).

CONCLUSIONThe level of NO(2)(-)/NO(3)(-)level in induced sputum has a positive correlation with exposure to dust, suggesting that there will be a certain feasibility of the NO(2)(-)/NO(3)(-)as indicators of early detection of silicosis.

Adult ; Humans ; Middle Aged ; Nitrates ; metabolism ; Nitrites ; metabolism ; Silicosis ; metabolism ; Sputum ; metabolism ; Tyrosine ; metabolism

BACKGROUND: Low-back pain (LBP) in nurses is a major health concern that affects their quality of life and ability to work, with consequences for their economic status. OBJECTIVE: This study evaluates the effect of low-level laser acupuncture combined with auricular acupressure (LAA) on pain intensity, pain interference and quality of life in nurses with LBP. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan, China. Participants were randomly assigned to the LAA group (n = 38) receiving low-level laser acupuncture and auricular acupressure for 4 weeks, and the control group (n = 38) receiving only sham laser acupuncture treatment without laser energy output. MAIN OUTCOME MEASURES: Data were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory, while the secondary outcome, quality of life, was evaluated using the Roland-Morris Disability Questionnaire. Both primary and secondary outcomes were scored before the intervention, and after 2-week and 4-week intervention. The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention. RESULTS: After controlling for prior pain, the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4 (P < 0.001), worst pain in week 2 (P < 0.001) and week 4 (P < 0.001), least pain in week 2 (P = 0.032) and week 4 (P < 0.001), pain interference in week 2 (P = 0.009) and week 4 (P < 0.001), and in the life dysfunction in week 2 (P < 0.001) and week 4 (P < 0.001). Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0% and 36.89% in the LAA group, and 69.44% and 36.11% in the control group. CONCLUSION: This study shows that 4-week LAA intervention reduced pain intensity and pain interference, and improved quality of life for hospital-based nurses with LBP. These effects were maintained continuously for at least 4 weeks after the intervention. The nonpharmacological intervention, LAA, may be another efficacious, feasible, noninvasive, analgesic intervention for LBP. TRIAL REGISTRATION This study is registered at Clinicaltrials.gov (registration number NCT04423445).
Humans ; Acupressure ; Quality of Life ; Treatment Outcome ; Low Back Pain/therapy* ; Acupuncture Therapy ; Nurses