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Objective: The purpose of this study is to investigate if an orally administered combination of aspirin and ketamine will provide better analgesia than a ketamine alone in adult patients presenting to the Emergency Department (ED) with acute musculoskeletal pain.Methods: We conducted a prospective, randomized, open-label trial of ED patients aged 18 and older presenting with moderate to severe acute musculoskeletal pain as defined by an 11-point numeric rating scale (NRS) with an initial score of ≥5. Patients were randomized to receive either 324 mg of VTS-Aspirin™ and 0.5 mg/kg of oral ketamine (AOK) that is directly swallowed or 0.5 mg/kg of oral ketamine (OK) alone that is swished first and then swallowed. Patients were assessed at baseline, 30, 60, 90, and 120 min. The primary outcome was a difference in pain scores between the two groups at 60 min post-administration. Secondary outcomes included adverse events and the need for rescue analgesia.Results: We enrolled 60 patients in the study (30 per group). The difference in mean pain scores at 60 min between the AOK and OK groups was 2.6 [95% CI: 1.38-3.77] showing a lower mean pain score in the OK group. At 60 min, the AOK group had a change in mean pain score from 8.4 to 6.3 (difference 2.1; 95% CI: 1.35-3.00). The OK group had a change in mean pain score from 7.8 to 3.7 (difference 4.1, 95% CI: 3.25-4.90). No clinically concerning changes in vital signs were observed. No serious adverse events occurred in either group. The most commonly reported adverse effects were dizziness and fatigue. None of the participants required rescue analgesia at 60 min post-medications administration.Conclusion: The administration of an oral combination of VTS-Aspirin ™ and ketamine resulted in less analgesia compared to oral ketamine alone, for the short-term treatment of moderate to severe acute musculoskeletal pain in the ED.Clinicaltrials: govRegistration: NCT04860804. [ABSTRACT FROM AUTHOR]

The main aim of this work was to study as mode factors as geological context, seasonal variation, typology and characteristic of single closed environments play on gas radon indoor pollution. To this purpose were monitored two hospital buildings of two Calabrian villages (South Italy): San Marco Argentano and Lungro placed in two different geological contexts underlining a different radiometric trend. Indoor radon concentrations were measured using integrating passive alpha track-etch detectors CR-39 type (Solid-State Nuclear Tracks Detectors (SSNTDs)) with three different measurement periods: 3 months, six months, 1 year. The obtained results show an annual overall average radon concentration of 74.84 Bq/m³ for the hospital building of San Marco Argentano and 28.83 Bq/m³ for the hospital building of Lungro. Besides a study of effective dose equivalent has carried out, under normal living conditions. The obtained results are lower than annual normative limit radon indoor of 500Bq/m³ and of effective dose equivalent 3 mSv/year (D.L 230/95, D. Lgs. n. 241/00). [ABSTRACT FROM AUTHOR]