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[PMID]:28500589
[Au] Autor:Park SK; Lee MG; Jeong SH; Yang HJ; Jung YS; Choi KY; Kim H; Kim HO; Jeong KU; Chun HK; Park DI
[Ad] Endereço:Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Korea.
[Ti] Título:Prospective Analysis of Minor Adverse Events After Colon Polypectomy.
[So] Source:Dig Dis Sci;62(8):2113-2119, 2017 Aug.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The risks of minor adverse events (MAEs) such as abdominal pain and bloating after colon polypectomy (CP) are less clearly documented than major adverse events. However, these complications may cause significant discomfort during the performance of normal activities. We aimed to estimate the incidence of MAE, associated risk factors, and healthcare resource utilization after CP. METHODS: Patients who underwent CP were prospectively enrolled in this study. Trained nurses contacted patients by telephone at 7 and 30 days after the CP and administered a standardized questionnaire to obtain information regarding the development of complications. MAEs were defined as any discomfort the patient experienced after CP excluding major bleeding, perforation, and post-polypectomy coagulation syndrome. RESULTS: Among a total of 2716 patients, 2253 patients completed the interview at 7 and 30 days. MAEs occurred in 263 patients (11.7%) before day 7, among which the most common were abdominal pain (4.5%), rectal bleeding (2.8%), and bloating (2.6%). Cumulative incidence of MAEs was in 267 patients (11.9%) at 30 days. On multivariate analysis, female sex (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.58-3.18) and use of meperidine (OR 1.54, 95% CI 1.04-2.27) were risk factors for the occurrence of MAEs. Two patients (0.7%) required hospital admission, 117 patients (43.8%) were treated medically in the outpatient clinic, and the majority at 148 patients (55.4%) experienced resolution of symptoms after observation. CONCLUSIONS: The post-CP MAE rate was as low as 11.8%. The MAEs occurred mainly in the first seven postoperative days and resulted in little use of healthcare resources.
[Mh] Termos MeSH primário: Pólipos do Colo/cirurgia
Colonoscopia/efeitos adversos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Dor Abdominal/epidemiologia
Dor Abdominal/etiologia
Analgésicos Opioides/efeitos adversos
Colonoscopia/métodos
Feminino
Hemorragia Gastrointestinal/epidemiologia
Hemorragia Gastrointestinal/etiologia
Seres Humanos
Masculino
Meperidina/efeitos adversos
Meia-Idade
Complicações Pós-Operatórias/etiologia
Período Pós-Operatório
Estudos Prospectivos
Reto
Fatores de Risco
Fatores Sexuais
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 9E338QE28F (Meperidine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170514
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4586-y


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[PMID]:28493767
[Au] Autor:Carter C; Viveash S
[Ad] Endereço:Nurse Tutor, Defence School of Healthcare Education, Department of Healthcare Education, Birmingham City University, and Intensive Care Nursing Officer, Queen Alexandra's Royal Army Nursing Corps.
[Ti] Título:Nursing a critically ill tetanus patient in an intensive care unit in Zambia.
[So] Source:Br J Nurs;26(9):489-496, 2017 May 11.
[Is] ISSN:0966-0461
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The global incidence of tetanus has been gradually reducing. Improvements in vaccination and health education programmes and the World Health Organization campaign to eradicate maternal and neonatal tetanus have all resulted in fewer presentations globally. Unfortunately, tetanus mortality remains a significant problem for many developing countries, owing to inadequate vaccination programmes or to conflict or humanitarian disasters during which vaccination programmes are stopped or there is sporadic cover. This case study explores the care of a tetanus patient in an intensive care unit in Zambia, a lower-middle-income country in sub-Saharan Africa.
[Mh] Termos MeSH primário: Enfermagem de Cuidados Críticos
Países em Desenvolvimento
Tétano/enfermagem
[Mh] Termos MeSH secundário: Analgésicos Opioides/uso terapêutico
Anti-Infecciosos/uso terapêutico
Anticonvulsivantes/uso terapêutico
Dor nas Costas/etiologia
Estado Terminal
Diazepam/uso terapêutico
Febre/etiologia
Seres Humanos
Imunoglobulinas/uso terapêutico
Fatores Imunológicos/uso terapêutico
Magnésio/uso terapêutico
Masculino
Meperidina/uso terapêutico
Metronidazol/uso terapêutico
Debilidade Muscular/etiologia
Dor/tratamento farmacológico
Dor/etiologia
Convulsões/tratamento farmacológico
Convulsões/etiologia
Tétano/complicações
Trismo/tratamento farmacológico
Trismo/etiologia
Adulto Jovem
Zâmbia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anti-Infective Agents); 0 (Anticonvulsants); 0 (Immunoglobulins); 0 (Immunologic Factors); 140QMO216E (Metronidazole); 9E338QE28F (Meperidine); I38ZP9992A (Magnesium); Q3JTX2Q7TU (Diazepam)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.12968/bjon.2017.26.9.489


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[PMID]:28405945
[Au] Autor:Swart LM; van der Zanden V; Spies PE; de Rooij SE; van Munster BC
[Ad] Endereço:Department of Internal Medicine, Geriatrics Section, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. l.m.swart@amc.uva.nl.
[Ti] Título:The Comparative Risk of Delirium with Different Opioids: A Systematic Review.
[So] Source:Drugs Aging;34(6):437-443, 2017 Jun.
[Is] ISSN:1179-1969
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: There is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of delirium from the use of various types of opioids in older patients. METHODS: We performed a search in MEDLINE by combining search terms on delirium and opioids. A specific search filter for use in geriatric medicine was used. Quality was scored according to the quality assessment for cohort studies of the Dutch Cochrane Institute. RESULTS: Six studies were included, all performed in surgical departments and all observational. No study was rated high quality, one was rated moderate quality, and five were rated low quality. Information about dose, route, and timing of administration of the opioid was frequently missing. Pain and other important risk factors of delirium were often not taken into account. Use of tramadol or meperidine was associated with an increased risk of delirium, whereas the use of morphine, fentanyl, oxycodone, and codeine were not, when compared with no opioid. Meperidine was also associated with an increased risk of delirium compared with other opioids, whereas tramadol was not. The risk of delirium appeared to be lower with hydromorphone or fentanyl, compared with other opioids. Numbers used for comparisons were small. CONCLUSION: Some data suggest that meperidine may lead to a higher perioperative risk for delirium; however, high-quality studies that compare different opioids are lacking. Further comparative research is needed.
[Mh] Termos MeSH primário: Analgésicos Opioides/efeitos adversos
Delírio/induzido quimicamente
Medição da Dor/métodos
Dor/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Analgésicos Opioides/uso terapêutico
Seres Humanos
Hidromorfona/efeitos adversos
Hidromorfona/uso terapêutico
Meperidina/efeitos adversos
Meperidina/uso terapêutico
Morfina/efeitos adversos
Morfina/uso terapêutico
Oxicodona/efeitos adversos
Oxicodona/uso terapêutico
Fatores de Risco
Tramadol/efeitos adversos
Tramadol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 39J1LGJ30J (Tramadol); 76I7G6D29C (Morphine); 9E338QE28F (Meperidine); CD35PMG570 (Oxycodone); Q812464R06 (Hydromorphone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170915
[Lr] Data última revisão:
170915
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1007/s40266-017-0455-9


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[PMID]:28322796
[Au] Autor:Aoyama Y; Sobue S; Mizutani N; Inoue C; Kawamoto Y; Nishizawa Y; Ichihara M; Kyogashima M; Suzuki M; Nozawa Y; Murate T
[Ad] Endereço:College of Life and Health Sciences, Chubu University, Kasugai, 487-8501, Japan.
[Ti] Título:Modulation of the sphingolipid rheostat is involved in paclitaxel resistance of the human prostate cancer cell line PC3-PR.
[So] Source:Biochem Biophys Res Commun;486(2):551-557, 2017 Apr 29.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Taxoids are anti-cancer drugs frequently used to treat solid tumors, but they are sometimes ineffective and tumors may become resistant to their action. Here, we examined the involvement of sphingolipid metabolic enzymes in paclitaxel (PTX) resistance using a human prostate cancer cell line, PC3, and its PTX-resistant subline, PC3-PR. PTX (20 nM) suppressed cell proliferation and increased various ceramide species in PC3, but not PC3-PR, cells. PC3-PR contained higher S1P levels than did PC3, regardless of PTX treatment. Western blotting revealed that PC3-PR cells expressed higher levels of sphingosine kinase 1 (SPHK1) and glucosylceramide synthase (GCS) but lower levels of acid sphingomyelinase (ASMase) and neutral sphingomyelinase 2 than did PC3 cells. Inhibition of SPHK1 using siRNA or a pharmacological inhibitor decreased S1P levels in PC3-PR cells and inhibited proliferation in the presence or absence of PTX, suggesting that SPHK1 is at least partially responsible for PTX resistance. Similarly, GCS inhibitors (PDMP and PPMP) increased cellular ceramides and suppressed the proliferation of PC3-PR. However, inhibition of proteasome function or histone deacetylase activity increased SMase and ceramide levels and suppressed PC3-PR proliferation. These results suggest that modulation of metabolic enzyme expression and alteration of the sphingolipid rheostat protects cancer cells against PTX.
[Mh] Termos MeSH primário: Antineoplásicos Fitogênicos/farmacologia
Resistência a Medicamentos Antineoplásicos/genética
Células Epiteliais/efeitos dos fármacos
Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos
Paclitaxel/farmacologia
Esfingolipídeos/metabolismo
[Mh] Termos MeSH secundário: Linhagem Celular Tumoral
Proliferação Celular/efeitos dos fármacos
Resistência a Medicamentos Antineoplásicos/efeitos dos fármacos
Inibidores Enzimáticos/farmacologia
Células Epiteliais/metabolismo
Células Epiteliais/patologia
Glucosiltransferases/antagonistas & inibidores
Glucosiltransferases/genética
Glucosiltransferases/metabolismo
Inibidores de Histona Desacetilases/farmacologia
Histona Desacetilases/genética
Histona Desacetilases/metabolismo
Seres Humanos
Células K562
Masculino
Meperidina/análogos & derivados
Meperidina/farmacologia
Morfolinas/farmacologia
Fosfotransferases (Aceptor do Grupo Álcool)/antagonistas & inibidores
Fosfotransferases (Aceptor do Grupo Álcool)/genética
Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo
Próstata/efeitos dos fármacos
Próstata/metabolismo
Próstata/patologia
Complexo de Endopeptidases do Proteassoma/efeitos dos fármacos
Complexo de Endopeptidases do Proteassoma/metabolismo
Inibidores de Proteassoma/farmacologia
RNA Interferente Pequeno/genética
RNA Interferente Pequeno/metabolismo
Fator de Transcrição Sp1/genética
Fator de Transcrição Sp1/metabolismo
Esfingomielina Fosfodiesterase/antagonistas & inibidores
Esfingomielina Fosfodiesterase/genética
Esfingomielina Fosfodiesterase/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Phytogenic); 0 (Enzyme Inhibitors); 0 (Histone Deacetylase Inhibitors); 0 (Morpholines); 0 (Proteasome Inhibitors); 0 (RNA, Small Interfering); 0 (Sp1 Transcription Factor); 0 (Sp1 protein, human); 0 (Sphingolipids); 13147-09-6 (4-propionyloxy-4-phenyl-N-methylpiperidine); 73257-80-4 (RV 538); 9E338QE28F (Meperidine); EC 2.4.1.- (Glucosyltransferases); EC 2.4.1.80 (ceramide glucosyltransferase); EC 2.7.1.- (Phosphotransferases (Alcohol Group Acceptor)); EC 2.7.1.- (sphingosine kinase); EC 3.1.4.- (acid sphingomyelinase-1); EC 3.1.4.12 (SMPD3 protein, human); EC 3.1.4.12 (Sphingomyelin Phosphodiesterase); EC 3.4.25.1 (Proteasome Endopeptidase Complex); EC 3.5.1.98 (Histone Deacetylases); P88XT4IS4D (Paclitaxel)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE


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[PMID]:28315010
[Au] Autor:Thanthong S; Rojthamarat S; Worasawate W; Vichitvejpaisal P; Nantajit D; Ieumwananontachai N
[Ad] Endereço:Department of Radiation Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy, 54 Kamphang Phet 6 Rd, Lak Si, Bangkok, 10210, Thailand. saengrawee81@gmail.com.
[Ti] Título:Comparison of efficacy of meperidine and fentanyl in terms of pain management and quality of life in patients with cervical cancer receiving intracavitary brachytherapy: a double-blind, randomized controlled trial.
[So] Source:Support Care Cancer;25(8):2531-2537, 2017 Aug.
[Is] ISSN:1433-7339
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to compare the effectiveness of two sedative regimens, a benzodiazepine with either meperidine or fentanyl, in relieving pain in patients with cervical cancer undergoing intracavitary brachytherapy in terms of pain score and quality of life. METHODS: Forty unselected outpatients undergoing brachytherapy (160 fractions) were enrolled with informed consent and randomized to receive a benzodiazepine with either meperidine or fentanyl. The perceived pain score according to a standard 10-item numeric rating scale was collected every 15 min during the procedure, and the perceived quality of life was determined at the end of each procedure using the EuroQol five-dimension questionnaire. The patients and medical staff members directly involved with the procedure were blinded to the medication used. RESULTS: The patients' pain levels were mild in both analgesic groups. Meperidine appeared to be slightly more effective than fentanyl, although the differences in the average pain score and quality of life were not statistically significant. CONCLUSION: Both meperidine and fentanyl in combination with benzodiazepine were effective in relieving pain and discomfort in patients undergoing brachytherapy. TRIAL REGISTRATION: NCT02684942, ClinicalTrials.gov.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Braquiterapia/métodos
Fentanila/uso terapêutico
Meperidina/uso terapêutico
Manejo da Dor/métodos
Qualidade de Vida/psicologia
Neoplasias do Colo do Útero/tratamento farmacológico
Neoplasias do Colo do Útero/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/farmacologia
Método Duplo-Cego
Feminino
Fentanila/administração & dosagem
Fentanila/farmacologia
Seres Humanos
Masculino
Meperidina/administração & dosagem
Meperidina/farmacologia
Meia-Idade
Neoplasias do Colo do Útero/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 9E338QE28F (Meperidine); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170319
[St] Status:MEDLINE
[do] DOI:10.1007/s00520-017-3662-3


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[PMID]:28249614
[Au] Autor:Dong CS; Zhang J; Lu Q; Sun P; Yu JM; Wu C; Sun H
[Ad] Endereço:Department of Anesthesiology, Third affiliation hospital of Anhui Medical University, Hefei huaihe road No. 390, Hefei, 230061, China. cxh0909@vip.126.com.
[Ti] Título:Effect of Dexmedetomidine combined with sufentanil for post- thoracotomy intravenous analgesia:a randomized, controlled clinical study.
[So] Source:BMC Anesthesiol;17(1):33, 2017 Mar 01.
[Is] ISSN:1471-2253
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Few studies have investigated the use of dexmedetomidine in patient-controlled intravenous analgesia (PCIA) after thoracic surgery. This study to evaluate the effect of dexmedetomidine combined with sufentanil for PCIA after thoracotomy under general anaesthesia. METHODS: Ninety-seven adults patients scheduled for thoracotomy surgery. All two groups received PCIA with either sufentanil alone (control group) or combining dexmedetomidine with sufentanil (dexmedetomidine group). Hemodynamic measurements, visual analog scale (VAS) scores at rest and at coughing, Ramsay sedation score (RSS), analgesic consumption, and postoperative nausea and vomiting (PONV) as well as drug-related adverse effects were compared at 2, 6, 12, 24, 36 and 48 h postoperatively. RESULTS: In the patients of the dexmedetomidine group, compared to the control group, the pain scores at rest or at coughing during 48 h postoperatively were lower (P < 0.001), the sedation scores were lower, the consumption of sufentanil and rescue meperidine were lower, and the number of episode of moderate PONV was three times lower. No signs of toxicity or local complications were observed. There was a non-significant trend for a lower HR and BP in the dexmedetomidine group vs. CONCLUSION: The combining dexmedetomidine with sufentanil for post-thoracotomy PCIA can improve pain control together with the decrease in sufentanil requirements, and improve postoperative patient's satisfaction compared with sufentanil alone in PCIA. TRIAL REGISTRATION: This trial was retrospectively registered on 27 April 2016 at the Chinese Clinical Trial Register (number: ChiCTR-ONC-16008376 ).
[Mh] Termos MeSH primário: Analgésicos não Entorpecentes/administração & dosagem
Analgésicos Opioides/administração & dosagem
Dexmedetomidina/administração & dosagem
Dor Pós-Operatória/prevenção & controle
Sufentanil/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Analgesia Controlada pelo Paciente
Pressão Sanguínea
Método Duplo-Cego
Quimioterapia Combinada
Frequência Cardíaca
Seres Humanos
Meperidina/uso terapêutico
Meia-Idade
Satisfação do Paciente
Toracotomia
Escala Visual Analógica
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Non-Narcotic); 0 (Analgesics, Opioid); 67VB76HONO (Dexmedetomidine); 9E338QE28F (Meperidine); AFE2YW0IIZ (Sufentanil)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1186/s12871-017-0324-4


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[PMID]:28228096
[Au] Autor:Aziato L; Acheampong AK; Umoar KL
[Ad] Endereço:Department of Adult Health, School of Nursing, College of Health Sciences, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana. aziatol@yahoo.com.
[Ti] Título:Labour pain experiences and perceptions: a qualitative study among post-partum women in Ghana.
[So] Source:BMC Pregnancy Childbirth;17(1):73, 2017 Feb 22.
[Is] ISSN:1471-2393
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Women have experienced severe labour pain over the years and various attempts have been made to effectively manage labour pain. However, there is paucity of literature on the labour pain experience and perceptions about labour pain with the contemporary Ghanaian health system. Therefore this study sought to gain an in-depth understanding on labour pain experiences and perceptions of post-partum women. METHODS: The study adopted an exploratory descriptive qualitative approach and collected data through individual interviews. Informed consent was obtained from all the participants who were purposively sampled. After transcription of interviews, the data were analyzed inductively using content analysis techniques. RESULTS: Women in this study experienced pain during labour rated as mild, moderate and severe and the pain was felt at the waist area, vagina, lower abdomen and the general body. The women expressed labour pain through crying, screaming and shouting. They prayed to God to help reduce the severe pain. Some women endured the pain, cried inwardly and others showed no sign of pain. Some women believed that crying during labour is a sign of weakness. Pain reliefs such as pethidine (Meperidine) was occasionally given. Non-pharmacologic measures employed included walking around, deep breathing, side-lying, waist holding, squatting, taking a shower and chewing gum. The individuality of pain experience and expression was emphasized and the socio-cultural orientation of women made some of them stoic. CONCLUSION: We concluded that it is necessary for all health professionals to manage labour pain effectively taking the socio-cultural context into consideration.
[Mh] Termos MeSH primário: Analgesia Obstétrica/métodos
Atitude Frente à Saúde
Dor do Parto
Trabalho de Parto
[Mh] Termos MeSH secundário: Adulto
Analgésicos Opioides/uso terapêutico
Exercícios Respiratórios
Feminino
Gana
Seres Humanos
Meperidina/uso terapêutico
Manejo da Dor/métodos
Medição da Dor
Posicionamento do Paciente
Período Pós-Parto
Gravidez
Pesquisa Qualitativa
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 9E338QE28F (Meperidine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.1186/s12884-017-1248-1


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[PMID]:28203021
[Au] Autor:Zhao MW; Wang N; Zeng L; Li M; Zhao ZK; Zhang H; Tian H
[Ad] Endereço:Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China.
[Ti] Título:[Comparision for clinical efficiency of continuous adductor canal block and femoral nerve block in total knee arthroplasty].
[So] Source:Beijing Da Xue Xue Bao Yi Xue Ban;49(1):142-7, 2017 02 18.
[Is] ISSN:1671-167X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To compare the pain control efficiency of continuous adductor canal block (ACB) and femoral nerve block (FNB) in total knee arthroplasty. METHODS: From April to September 2016, patients with severe knee osteoarthritis undergoing primary unilateral total knee arthroplasty (TKA) were prospectively observed, and all the patients were randomized received ultrasound-guided continuous ACB or FNB after surgery. Numeric pain rating scales(NPRS)pain scores in rest and activity 2, 6, 12, 24 and 48 h after surgery were collected, and the preoperative and postoperative quadriceps strength at 24 and 48 h were analyzed. Opioids consumption and anesthesia related adverse effects were also recorded. RESULTS: In the study, 40 patients were enrolled, with 20 patients in each group, male:female=7:33, the age: (63.8±10.1) years, and the body mass index (BMI): (28.5±3.5) kg/m(2).The general conditions were comparable between the two groups. Though the rest pain 2 h after surgery [ACB=0.0(0,6), FNB=3.0(0,5), P=0.004] and activity pain 12 h post operation [ACB=3.0(3,0), FNB=5.5(0,10), P=0.004] were lower in ACB group compared with FNB group, there was no statistical difference in the other pain checking points between the two groups. The quadriceps strength 24 h and 48 h after surgery were(85.3±27.6) N and (80.0±30.1) N in ACB group, (69.0±29.4) N and (64.4±32.0) N in FNB group, both of them were declined by time. The exact data were higher in ACB group, however, there was no statistical difference between the two group by repeated measurements variance analysis(F=2.703, P=0.108).Four patients in ACB group and five in FNB acquired additional use of dolantin once (100 mg/per time) within 24 h. And among them, three patients acquired once dolantin in ACB, two in FNB, from 24 to 48 h postoperation. There were five patients who suffered nausea postoperation in ACB group, and one who reported xerostomia. Four patients in FNB had nausea with vomiting, and three experienced xerostomia. Deep vein thrombosis appeared in 2 patients in FNB group, but no one in ACB group. CONCLUSION: Continuous ACB is not superior in pain control after TKA compared with FNB, and the quadriceps strength could be reserved more by this method, which performed early benefits in fast rehabilitation.
[Mh] Termos MeSH primário: Artroplastia do Joelho/reabilitação
Bloqueio Nervoso/efeitos adversos
Bloqueio Nervoso/métodos
Manejo da Dor/métodos
Dor Pós-Operatória/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/uso terapêutico
Pesquisa Comparativa da Efetividade
Feminino
Nervo Femoral/efeitos dos fármacos
Seres Humanos
Masculino
Meperidina/administração & dosagem
Meperidina/uso terapêutico
Meia-Idade
Força Muscular/efeitos dos fármacos
Manejo da Dor/efeitos adversos
Complicações Pós-Operatórias/epidemiologia
Náusea e Vômito Pós-Operatório
Músculo Quadríceps/inervação
Resultado do Tratamento
Xerostomia/epidemiologia
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 9E338QE28F (Meperidine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE


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[PMID]:28119437
[Au] Autor:Wu F; Slawson MH; Johnson-Davis KL
[Ad] Endereço:Department of Pathology, University of UtahHealth Sciences Center, Salt Lake City, UT 84108, USA.
[Ti] Título:Metabolic Patterns of Fentanyl, Meperidine, Methylphenidate, Tapentadol and Tramadol Observed in Urine, Serum or Plasma.
[So] Source:J Anal Toxicol;41(4):289-299, 2017 May 01.
[Is] ISSN:1945-2403
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Drug testing is a useful tool to identify drug use or monitor adherence to prescription drugs. The interpretation of drug results can be complicated based on the pattern and proportional concentrations of drugs and/or drug metabolite(s). The purpose of this retrospective study was to detect the positivity rates and metabolic patterns of five prescription drugs, including fentanyl, meperidine, methylphenidate, tapentadol and tramadol. Retrospective data were retrieved from the laboratory information system in a national reference laboratory. Drug testing was performed using four mass spectrometry methods that were validated for clinical use. For urine specimens, the positivity rate was the highest for methylphenidate (62.3%, n = 2,489), followed by tramadol (43.7%, n = 3,483), fentanyl (41.9%, n = 4,657), tapentadol (37.9%, n = 736) and meperidine (8.3%, n = 138). Among positive samples, both parent drug and metabolite(s) was detectable in 94.9% of meperidine samples, 94.5% of tramadol samples, 93.8% of fentanyl samples, 89.9% of methylphenidate and 86.6% of tapentadol samples. For serum or plasma specimens, the positivity rate was the highest for tapentadol (75.0%, n = 39), followed by methylphenidate (74.2%, n = 569), fentanyl (53.6%, n = 113), meperidine (41.9%, n = 18) and tramadol (28.9%, n = 213). Similar metabolic patterns were found in serum or plasma. Of positive results, both parent drug and metabolite(s) were found in 94.7% of fentanyl samples, 83.3% of meperidine samples, 79.6% of methylphenidate samples, 53.8% of tapentadol samples and 44.1% of tramadol samples. Our data demonstrates the metabolic patterns of five drugs from a random urine or serum/plasma collection in patients that have been prescribed these medications. The data presented can be used to guide clinicians in determining drug adherence by assessing the positivity rates of the parent drug and corresponding metabolite(s).
[Mh] Termos MeSH primário: Analgésicos Opioides/sangue
Analgésicos Opioides/urina
Medicamentos sob Prescrição/metabolismo
Detecção do Abuso de Substâncias/métodos
[Mh] Termos MeSH secundário: Fentanila/sangue
Fentanila/urina
Seres Humanos
Meperidina/sangue
Meperidina/urina
Metilfenidato/sangue
Metilfenidato/urina
Fenóis/sangue
Fenóis/urina
Plasma/metabolismo
Tramadol/sangue
Tramadol/urina
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Phenols); 0 (Prescription Drugs); 207ZZ9QZ49 (Methylphenidate); 39J1LGJ30J (Tramadol); 9E338QE28F (Meperidine); H8A007M585 (tapentadol); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170726
[Lr] Data última revisão:
170726
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1093/jat/bkx003


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[PMID]:28027453
[Au] Autor:Breazu CM; Ciobanu L; Bartos A; Bodea R; Mircea PA; Ionescu D
[Ad] Endereço:University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania; Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, Cluj-Napoca, Romania. csbreazu@yahoo.com.
[Ti] Título:Pethidine efficacy in achieving the ultrasound-guided oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy: A prospective study.
[So] Source:Bosn J Basic Med Sci;17(1):67-73, 2017 Feb 21.
[Is] ISSN:1840-4812
[Cp] País de publicação:Bosnia and Herzegovina
[La] Idioma:eng
[Ab] Resumo:Pethidine is a synthetic opioid with local anesthetic properties. Our goal was to evaluate the analgesic efficacy of pethidine for achieving the ultrasound-guided oblique subcostal transversus abdominis plane (OSTAP) block in laparoscopic cholecystectomy. This prospective, double-blind study included 79 patients of physical status I and II according to American Society of Anesthesiologists, scheduled for elective laparoscopic cholecystectomy. The patients were randomly allocated into three groups, depending on the drug used to achieve preoperative bilateral OSTAP block: 1) OSTAP-Placebo (treated with normal saline); 2) OSTAP-Bupivacaine (treated with 0.25% bupivacaine); and 3) OSTAP-Pethidine (treated with 1% pethidine). The efficacy of pethidine in achieving the OSTAP block was analyzed using visual analog scale (VAS), intraoperative opioid dose, opioid consumption in post anesthesia care unit, and opioid consumption in the first 24 postoperative hours. The pain scores assessed by VAS at 0, 2, 4, 6, 12, and 24 hours were significantly lower in OSTAP-Pethidine than in OSTAP-Placebo group (p < 0.001). The mean intraoperative opioid consumption was significantly lower in OSTAP-Pethidine compared to OSTAP-Placebo group (150 versus 400 mg, p < 0.001), as well as the mean opioid consumption in the first 24 hours (20.4 versus 78 mg, p < 0.001). Comparing VAS assessment between OSTAP-Bupivacaine and OSTAP-Pethidine groups, statistically significant differences were observed only for the immediate postoperative pain assessment (0 hours), where lower values were observed in OSTAP-Pethidine group (p = 0.004). There were no statistically significant differences in the incidence of postoperative nausea and vomiting (p = 0.131) between the groups. The use of 1% pethidine can be an alternative to 0.25% bupivacaine in achieving OSTAP block for laparoscopic cholecystectomy.
[Mh] Termos MeSH primário: Músculos Abdominais/diagnóstico por imagem
Músculos Abdominais/cirurgia
Colecistectomia Laparoscópica
Meperidina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Analgésicos Opioides/administração & dosagem
Anestésicos Locais/administração & dosagem
Bupivacaína/administração & dosagem
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Meia-Idade
Manejo da Dor
Medição da Dor
Dor Pós-Operatória/tratamento farmacológico
Estudos Prospectivos
Fatores de Tempo
Ultrassom
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 9E338QE28F (Meperidine); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170403
[Lr] Data última revisão:
170403
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161228
[St] Status:MEDLINE
[do] DOI:10.17305/bjbms.2016.1647



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