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The formula-based estimation of the right internal jugular venous (IJV) catheterization depth can be inaccurate when using ultrasound guidance. External landmark-based and radiological landmark-based methods have been proposed as alternatives to estimate the insertion depth. This study aimed to evaluate these methods using transesophageal echocardiography (TEE)-guided insertion depth as the reference. Ninety-seven adult cardiac surgery patients underwent real-time ultrasound-guided right IJV catheterization, with placement at the superior vena cava-right atrium (SVC-RA) junction under TEE guidance. The primary outcome compared the accuracy of external-landmark and radiological-landmark methods in estimating optimal catheter position (2 cm above to 1 cm below the SVC-RA junction), while secondary outcomes assessed their reliability and agreement with TEE. The external-landmark method proved more accurate than the radiological-landmark method (91.8% vs. 68%, p < 0.001) and had a higher correlation with TEE (r = 0.83 vs. 0.67). Bland–Altman analysis showed a mean difference of 0.08 cm between external-landmark and TEE methods (limits of agreement: -1.75 to 1.90 cm) and 0.43 cm for radiological-landmark (limits of agreement: -2.63 to 3.49 cm). Overall, the external-landmark method is a reliable and simple technique for estimating right IJV catheter depth and is more useful in cardiac surgery compared to the radiological-landmark method. Trial registration Thai Clinical Trials Registry (TCTR20200410012). Date registered April 9, 2020. [ABSTRACT FROM AUTHOR]

Background/Objective: We assessed the analgesic and anti-inflammatory effects of kale extract (500 mg anthocyanin equivalent) in patients after mandibular molar surgery. Methods: In our randomized clinical trial, postoperative subjects (n = 20) aged 18–25 years old took kale extract or ibuprofen (400 mg) capsules for 7 days, or vice versa, after surgical removal of each impacted tooth. Their pain intensity was then assessed using a visual analogue scale (VAS). Moreover, salivary α-amylase (AA) activity, matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta2 (TGF-β2) concentrations were measured. Levels of VAS and AA decreased 7 days after the first and second molar extractions in the two treatment groups. Results: The kale extract was more effective than ibuprofen. MMP-9 and TGF-β2 levels were reduced on days 4 and 7 following the two extractions in the kale group, whereas they were reduced on days 4 and 7 following the first extraction in the ibuprofen group. There was a positive correlation between MMP-9 and TGF-β2. Thus, the consumption of the kale extract exerted analgesic and anti-inflammatory effects during the postoperative period in patients who had undergone molar extractions. In conclusion, anthocyanin-abundant kale extract is preferable when administered in a postoperative course and could reduce the need for a prescription of ibuprofen. [ABSTRACT FROM AUTHOR]