The Benefit of Hydrogen Gas as an Adjunctive Therapy for Chronic Obstructive Pulmonary Disease.

Background and Objectives: Recent studies suggest that hydrogen gas possesses anti-inflammatory, antioxidant, and anti-apoptotic properties. This study aimed to explore the therapeutic potential of hydrogen gas and assess its safety and tolerability in individuals with chronic obstructive pulmonary disease (COPD). Materials and Methods: Enrolled COPD patients received standard treatments along with additional hydrogen inhalation for 30 min in the morning, afternoon, and evening over a 30-day period. The assessment included changes in the COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) Dyspnea Scale, lung function, sleep quality, inflammation markers, and oxidative stress markers before and after hydrogen inhalation. Results: Six patients participated in this study. Patients 2, 3, 4, 5, and 6 demonstrated improvements in CAT scores following hydrogen gas intervention, with patients 2, 4, 5, and 6 also showing improvements in mMRC scores. Statistically, this study revealed significant improvements in CAT [15.5 (10.5-19.75) vs. 8.5 (3-13.5); p = 0.043] and mMRC scores [2.5 (1-4) vs. 2 (0-3.25); p = 0.046] before and after intervention, respectively. However, no significant differences were observed in lung function, DLCO, sleep quality, and 6 MWT before and after hydrogen therapy. CBC examination showed a significant difference in platelet count before and after treatment [247 (209.75-298.75) vs. 260 (232.75-314.5); p = 0.043], respectively, while other blood tests, inflammation markers, and oxidative stress markers did not exhibit significant differences before and after hydrogen therapy. All patients experienced no obvious side-effects. Conclusions: Adjuvant therapy with hydrogen gas demonstrated symptom improvements in specific COPD patients, and no significant adverse effects were observed in any of the patients. Hydrogen gas may also exert a modulatory effect on platelet count.

Patient-reported outcome measures to evaluate postoperative quality of life in patients undergoing elective abdominal surgery: a systematic review.

PURPOSE: To appraise the measurement properties of generic patient-reported outcome measures (PROMs) measuring postoperative quality of life in adults undergoing elective abdominal surgery. METHODS: We conducted a systematic review of PROMs administered after elective abdominal surgery. We systematically searched Ovid MEDLINE, Embase, the Cumulative Index to Nursing & Allied Health Literature database, and the Cochrane Library from earliest available dates to July 24, 2021, using relevant search terms. Articles were included if they reported assessment of measurement properties of a generic PROM/s measuring postoperative quality of life in adults who had undergone elective abdominal surgery. We used the Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) Risk of Bias checklist to assess methodological quality. We synthesized the data and used the COSMIN criteria for good measurement properties and the Grading of Recommendations, Assessment, Development and Evaluations criteria to rate the certainty of evidence. RESULTS: Of 12,121 identified articles, nine articles assessing five PROMs (SF-6D, EQ-5D, SF-36, SF-12, PROMIS-10) met inclusion criteria. Measurement properties assessed included internal consistency (n = 2), construct validity (n = 5), and responsiveness (n = 8). Two PROMs had high quality evidence for a single measurement property each. The SF-6D demonstrated high quality evidence for responsiveness and the EQ-5D had high quality evidence for construct validity. CONCLUSION: There is insufficient evidence to support the choice of a specific generic PROM to evaluate quality of life following elective abdominal surgery. Clinicians and researchers should be aware of the current limitations in knowledge of the measurement properties of available PROMs.

Nursing home resident deaths due to road trauma and the potential roles for nursing home providers to promote public safety.

OBJECTIVE: This commentary aimed to determine whether nursing home (NH) providers have a responsibility for the safe mobility of residents outside the facility. METHODS: The Safe System approach was applied to NH resident road safety, and fatality crash data involving NH residents were reviewed, to identify potential countermeasures to prevent injurious road crashes for older people living in a NH. RESULTS: Viewing NH resident road safety through the Safe System approach identified actions that NH providers can take to actively contribute to: safe roads/roadsides for residents by better land use, infrastructure and design improvements; ensuring vehicles purchased and used for transporting residents have safety features; safe speed zones within and on nearby streets to NH; and safer road user behaviour through ensuring travel care plans for each resident. CONCLUSION: Applying the Safe System approach has provided new and innovative insights into how road safety can be improved for NH residents.

Fatal road transport crashes among Australian residential aged care facility residents.

OBJECTIVE: To examine fatal road transport crashes of residential aged care facility (RACF) residents to determine crash characteristics and risk factors. METHODS: A cross-sectional study of a retrospective national cohort of RACF resident deaths notified to Australian coroners. INCLUSION CRITERIA: death occurred between 1 July 2000 and 30 June 2013; mechanism classified as 'transport injury event'; and completed coronial investigation. Descriptive statistical analyses were conducted on crash characteristics and risk factors. RESULTS: Thirty-eight deaths met the inclusion criteria. Median age of deceased RACF residents was 84 years, and gender was equally distributed. Men were most frequently pedestrians (n = 14, 37%), and women were most frequently motor vehicle passengers (n = 14, 37%). Road user factors contributed to two-thirds of crashes (n = 25, 66%), with 'failure to yield' (n = 17, 45%) most frequent. CONCLUSION: Reducing fatal crashes of RACF residents requires effective road safety strategies and public awareness of risks for this increasing and vulnerable population.

Decreased incidence of glaucoma in children with asthma using inhaled corticosteroid: a cohort study.

Among the anti-inflammatory medications used for treating asthma, corticosteroids are the most effective. The effects of orally administered corticosteroids on intraocular pressure and lens opacity have been well defined, but the influence of inhaled corticosteroids (ICS) on children has yet to be clearly explained. Therefore, we used a nationwide cohort database to investigate glaucoma in childhood asthma patients using ICS. We analyzed a dataset of 1,000,000 randomly sampled individuals from Taiwan's 2000 National Health Insurance Research Database. The study cohort included 5,380 patients who were first diagnosed with asthma (ICD9: 493.X) diagnosis when they were six years old or younger. All subjects were followed through December 2011. We applied Cox's proportional hazard model to determine whether ICS use has a correlation with glaucoma. Of the 5,380 patients enrolled in this study, we identified 1,232 patients who had used ICS and 4,148 patients who had no history of ICS administration throughout the follow-up period. The prevalence of glaucoma was significantly lower in patients using ICS, with a 0.52-fold decreased risk of developing glaucoma in comparison to the control group [adjusted hazard ratio (HR) 0.52, 95% confidence interval (CI) 0.28∼0.96]. Among the evaluated comorbidities, cataract was positively associated with glaucoma in asthma children (adjusted HR 8.22; 95% CI = 2.59∼26.12). This study provides not only the first but also strong evidence that the glaucoma incidence in the ICS group is lower than that in the non-ICS group in children with asthma. Further consultation with an ophthalmologist regarding the high-risk group of asthma children with cataracts is necessary.

Cardioprotective effects of epigallocatechin-3-gallate against doxorubicin-induced cardiomyocyte injury.

Doxorubicin-induced generation of reactive oxygen species is a leading cause of cardiomyopathy, the major side-effect limiting the clinical use of this anti-cancer drug. Epigallocatechin-3-gallate (EGCG), a main catechin in green tea that possesses a strong antioxidant property. This study aims to investigate whether EGCG can protect cardiac myocytes against doxorubicin-induced myocyte injury. Myocyte viability was measured with an MTT assay. Reactive oxygen species were measured with fluorescent dye 2',7'-dichlorodihydrofluorescein diacetate. Myocyte shortening and intracellular Ca(2+) levels were determined with a spectrofluorometer connected to a video edge detection system. EGCG concentration-dependently increased cell viability and inhibited the generation of reactive oxygen species in doxorubicin-treated myocytes. Doxorubicin significantly decreased the amplitudes of cell shortening, the maximum velocity of cell contraction (+dl/dt) and relaxation (-dl/dt) in electrically-stimulated myocytes in the presence or absence of isoprenaline, which was attenuated by EGCG. The present data suggest that EGCG may protect myocytes against oxidative stress-induced cellular injury in doxorubicin-treated cardiac myocytes. The effect of EGCG on Ca(2+) handling was also examined. EGCG increased the amplitudes of both electrically- and caffeine-induced Ca(2+) transients in doxorubicin-treated myocytes, suggesting that EGCG may reverse doxorubicin-induced intracellular Ca(2+) depletion in the sarcoplasmic reticulum. We found in the present study that EGCG may protect heart against doxorubicin-induced myocyte injury by improving Ca(2+) handling through scavenging reactive oxygen species. Our results imply that EGCG may be used together with doxorubicin to minimize its cardiac toxic effects.