Highlighting the Advantages and Benefits of Non-NSAID Treatment After Total Knee Arthroplasty: A Cross-sectional Study.

BACKGROUND/AIM: Osteoarthritis is one of the most common degenerative conditions that causes pain, stiffness, and decreased functionality. The management of knee osteoarthritis necessitates collaboration among specialists from different disciplines, considering the primary clinical manifestations and functional level of the disease. The aim of this study was to highlight the disparities in postoperative outcomes between knee arthroplasty procedures with and without non-steroidal anti-inflammatory drugs (NSAIDs). The study specifically focuses on the immediate advantages and outcomes observed at the 6-month milestone. PATIENTS AND METHODS: This study followed 713 patients who were randomly divided into two groups: a group that did not receive non-steroidal anti-inflammatory drugs (N-NSAIDs) consisting of 394 patients, and a group that received non-steroidal anti-inflammatory drugs (NSAIDs) comprising 319 patients. The study spanned a duration of 5 years (2018-2022), with patients being followed and evaluated for up to 6 months after the surgery. RESULTS: It was observed that, from a therapeutic standpoint, the use of injectable treatments decreased. Significantly better differences were recorded in the N-NSAIDs group regarding return to pre-osteoarthritis activities at 6 months and reduced or absent night pain at 3 months (p<0.05). CONCLUSION: Statistically significant improvements were observed in the N-NSAIDs group concerning the ability to resume pre-osteoarthritis activities within 6 months, as well as a reduction or absence of nighttime pain within 3 months.

Correlations between Endoscopic and Histopathological Assessment of Helicobacter pylori-Induced Gastric Pathology-A Cross-Sectional Retrospective Study.

Helicobacter pylori (H. pylori) infects about half of the world's population and can lead to premalignant lesions and gastric cancer. Updated data about the correlation of histopathological diagnostics with endoscopic diagnostics are scarce. The objective of this study was to identify the concordance between endoscopic and histopathologic findings, with a focus on premalignant lesions. We performed a cross sectional, retrospective study over a 4-year period (2017−2021) on adult patients with dyspeptic symptoms and positive RUT (rapid urease test) in a single hospital centre, with a total of 133 patients infected with H. pylori being included in the study. Statistical associations between endoscopic appearance and histopathological results were found for atrophic antral gastritis (p = 0.001), intestinal metaplasia of the antrum (p = 0.018), gastric polyps (p < 0.001) and gastric corpus cancer (p = 0.012). Females were more likely to be diagnosed through endoscopy with gastric atrophy or intestinal metaplasia (p = 0.031), while chronic atrophic gastritis in corpus was more prevalent in patients older than 65 (p = 0.024). Overall, our study reveals only 21% concordance between Giemsa stain and RUT, highlighting the importance of combining rapid testing with endoscopic and histopathological diagnostic methods for a more accurate early diagnosis and prevention of gastric cancer.

Correlation between Carbonic Anhydrase Isozymes and the Evolution of Myocardial Infarction in Diabetic Patients.

(1) Background: Myocardial infarction was, until recently, recognized as a major coronary event, often fatal, with major implications for survivors. According to some authors, diabetes mellitus is an important atherogenic risk factor with cardiac determinations underlying the definition of the so-called "diabetic heart". The present study aims to establish a correlation between the evolution of myocardial infarction in diabetic patients, by determining whether lactic acid levels, the activity of carbonic anhydrase isoenzymes, and the magnitude of ST-segment elevation are correlated with the subsequent evolution of myocardial infarction. (2) Methods: The study analyzed 2 groups of 30 patients each: group 1 consisted of diabetic patients with acute myocardial infarction, and group 2 consisted of non-diabetic patients with acute myocardial infarction. Patients were examined clinically and paraclinical, their heart markers, lactic acid, and the activity of carbonic anhydrase I and II isozymes were determined. All patients underwent electrocardiogram and echocardiography analyses. (3) Results: The results showed that diabetics develop acute myocardial infarction more frequently, regardless of how much time has passed since the diagnosis. The value of myocardial necrosis enzymes was higher in diabetics than in non-diabetics, and acute coronary syndrome occurs mainly in diabetics with poor metabolic balance. Lethality rates in non-diabetic patients with lactic acid values above normal are lower than in diabetics. (4) Conclusions: Lactic acid correlated with the activity of isozyme I of carbonic dioxide which could be early markers of the prognosis and evolution of diabetic patients with acute myocardial infarction.

Antiepileptic Drugs and Their Dual Mechanism of Action on Carbonic Anhydrase.

(1) Background: The benefit of using inhibitors of carbonic anhydrase (CA), such as acetazolamide, in the treatment of epilepsy has previously been described. (2) Methods: In this paper, the effect on CA of the most well-known antiepileptic drugs was studied in vitro and in vivo. The effects, after chronic treatment, of carbamazepine, phenytoin, valproate, primidone, clonazepam, and ethosuximide were studied in vitro on purified CA, isozyme I (CA I) and CA, and isozyme II (CA II) activity and in vivo on epileptic erythrocyte CA I and CA II activity. (3) Results: In vitro results showed that all antiepileptic drugs reduced purified CA II activity according to dose-response relationships and slightly inhibited CA I activity. In vivo results showed that the chronic administration of antiseizure drugs induced a progressive reduction in erythrocyte CA II activity in all the groups studied. This study shows that CA II inhibition can be induced both in vitro and in vivo by major antiepileptic agents as it might be one of the effective mechanisms of these anticonvulsant drugs. (4) Conclusions: The decrease in CA II activity in epileptic patients after antiseizure treatment suggests the involvement of CA II in the pathogenesis of epilepsy.