Base de dados : MEDLINE
Pesquisa : D03.633.100.473.420.485 [Categoria DeCS]
Referências encontradas : 1307 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 131 ir para página                         

  1 / 1307 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29229151
[Au] Autor:Kowalsky SJ; Zenati MS; Steve J; Lee KK; Hogg ME; Zeh HJ; Zureikat AH
[Ad] Endereço:Division of Surgical Oncology, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
[Ti] Título:Ketorolac use may increase risk of postoperative pancreatic fistula after pancreaticoduodenectomy.
[So] Source:J Surg Res;221:43-48, 2018 Jan.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ketorolac (Toradol), a commonly used nonselective nonsteroidal anti-inflammatory drug (NSAID) in the postoperative period, has been associated with increased risk of anastomotic leak after colon resection. The effect of postoperative NSAID and ketorolac use on postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is unknown. METHODS: Retrospective review of consecutive PDs at a high-volume pancreas center from 2012 to 2015. POPF was identified and graded using International Study Group on Pancreatic Fistula criteria. Demographics, operative variables and 30-d postoperative NSAID use, dosage, and timing (early = postoperative day [POD] 0-5, late > POD 5) were collected. Univariate and multivariate logistic regressions were used to identify predictors of POPF. RESULTS: Four hundred twenty-three PDs were analyzed (mean age 66 y, 47% female), and 60% received NSAIDs postoperatively. Ketorolac (median POD 0-5 cumulative dose = 90 mg, interquartile range 60-165) was used in 35.7% (n = 151). POPF occurred in 90 patients (21.3%). Early (POD 0-5) ketorolac use was associated with increased POPF, especially grade A (odds ratio [OR] 2.16, P = 0.036). Each 25 mg incremental increase in ketorolac use was associated with a 10% increase in the incidence of POPF (OR 1.10, P = 0.021), whereas a cumulative dose of >150 mg was associated with a 44% increased risk of POPF (OR 1.44, 95% confidence interval 1.03-2.01, P = 0.035). A multivariate regression model identified estimated blood loss, soft gland, pancreatic duct diameter, body mass index, and cumulative ketorolac dose >150 mg as independent predictors of POPF (P < 0.0001, pseudo R = 0.149). CONCLUSIONS: Increasing doses of ketorolac in the early postoperative period are associated with increased risk of POPF, whereas a cumulative dose of >150 mg is an independent predictor of POPF after PD.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/efeitos adversos
Cetorolaco/efeitos adversos
Fístula Pancreática/induzido quimicamente
Pancreaticoduodenectomia
Complicações Pós-Operatórias/induzido quimicamente
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE


  2 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28468607
[Au] Autor:Kuchálik J; Magnuson A; Tina E; Gupta A
[Ad] Endereço:Department of Anesthesiology and Intensive Care, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
[Ti] Título:Does local infiltration analgesia reduce peri-operative inflammation following total hip arthroplasty? A randomized, double-blind study.
[So] Source:BMC Anesthesiol;17(1):63, 2017 05 03.
[Is] ISSN:1471-2253
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Postoperative inflammation following total hip arthroplasty (THA) can lead to delayed mobilization and return of hip function. Our primary aim was to assess whether local infiltration analgesia (LIA) during surgery can prevent postoperative inflammation. METHODS: This is a sub-analysis of data from a broader double-blind study where 56 patients received spinal anaesthesia for THA. Additionally, Group FNB (Femoral Nerve Block) received an ultrasound-guided femoral nerve block using 30 mL of ropivacaine 7.5 mg/mL (225 mg), and 151.5 mL of saline peri-articularly intra-operatively. Group LIA received 30 mL saline in the femoral nerve block and ropivacaine 2 mg/mL, 300 mg (150 mL) + ketorolac 30 mg (1 mL) + adrenaline 0.5 mg (0.5 mL) peri-articularly. After 23 h, the LIA mixture (22 mL) was injected via a catheter placed peri-articularly in Group LIA and 22 mL saline in Group FNB. A battery of pro- and anti-inflammatory cytokines was assessed using a commercially available kit preoperatively and after 4 h and 3 days postoperatively. Additionally, CRP, platelet count and white blood count was determined pre- and postoperatively. RESULTS: There was a general trend towards an increase in pro-inflammatory cytokines postoperatively, which returned to normal levels after 3 days. IL-6 concentration was significantly lower 4 h postoperatively in Group LIA compared to Group FNB (p = 0.015). No other significant differences were found between the groups in other cytokines. CRP levels were significantly higher in Group FNB compared to Group LIA 3 days postoperatively (p < 0.001). No other significant differences were seen between the groups. CONCLUSION: Local infiltration analgesia has a modest but short-lasting effect on postoperative inflammation in patients undergoing total hip arthroplasty. This is likely to be due to local infiltration of ketorolac and/or local anaesthetics in the LIA mixture. Future studies should be directed towards assessing whether the use of LIA translates into better patient outcomes. TRIAL REGISTRATION: EudraCT Number 2012-003875-20 . Registered 3 December 2012.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Inflamação/tratamento farmacológico
Bloqueio Nervoso
[Mh] Termos MeSH secundário: Amidas/administração & dosagem
Anestésicos Locais/administração & dosagem
Anti-Inflamatórios não Esteroides/administração & dosagem
Proteína C-Reativa/análise
Citocinas/sangue
Método Duplo-Cego
Feminino
Nervo Femoral
Seres Humanos
Inflamação/etiologia
Cetorolaco/administração & dosagem
Masculino
Meia-Idade
Complicações Pós-Operatórias/tratamento farmacológico
Complicações Pós-Operatórias/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Amides); 0 (Anesthetics, Local); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Cytokines); 7IO5LYA57N (ropivacaine); 9007-41-4 (C-Reactive Protein); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1186/s12871-017-0354-y


  3 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28985855
[Au] Autor:Naseem HU; Dorman RM; Ventro G; Rothstein DH; Vali K
[Ad] Endereço:Department of Pediatric Surgery, Women and Children's Hospital of Buffalo, Buffalo, New York. Electronic address: hnaseem@kaleidahealth.org.
[Ti] Título:Safety of perioperative ketorolac administration in pediatric appendectomy.
[So] Source:J Surg Res;218:232-236, 2017 Oct.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Recent studies in adults undergoing gastrointestinal surgeries show an increased rate of complications with the use of ketorolac. This calls into question the safety of ketorolac in certain procedures. We sought to evaluate the impact of perioperative ketorolac administration on outcomes in pediatric appendectomy. METHODS: The Pediatric Health Information System database was queried for patients aged 5-17 y with a primary diagnosis of appendicitis and a primary procedure of appendectomy during the period 2010-2014. Patients with procedures suggesting incidental appendectomy, those records with data quality issues, deaths, and extracorporeal membrane oxygenation were excluded. Variables recorded included age, sex, race, ethnicity, discharge year, complex chronic conditions, geographic region, intensive care unit admission, mechanical ventilation, and whether appendicitis was coded as complicated. The exposure variable was ketorolac administration on the day of or day after operation. The primary outcomes of interest were any surgical complications during the initial encounter, postoperative length of stay (LOS), total cost for the initial visit, any readmission to ambulatory, observation, or inpatient status within 30 d, and readmission with a diagnosis of peritoneal abscess or other postoperative infection or with transabdominal drainage performed. RESULTS: A total of 78,926 patients were included in the analysis cohort. Mean age was 11.4 y (standard deviation 3.3 y), the majority were males (61%), White (70%), and non-Hispanic (65%). Few had a complex chronic condition (3%) or required mechanical ventilation (2%) or an intensive care unit admission (1%). Patients with complicated appendicitis comprised 28% of the cohort. Most (73%) received ketorolac on postoperative day 0-1; those with complicated appendicitis were more likely to receive ketorolac. In all, 2.6% of the cohort had a surgical complication during the index visit, 4.3% were readmitted within 30 d, and 2% had a postoperative infection or transabdominal drainage (1% in the uncomplicated group and 5% in the complicated group). Median postoperative LOS was 1 d and mean cost was $9811 ± $9509. On bivariate analysis, ketorolac administration was associated with a decrease in same-visit surgical complications (P = 0.004) and cost ($459 decrease, P < 0.001) but was not associated with readmission, postoperative LOS, or postoperative infection. On multivariate analysis, ketorolac administration was associated with a significant decrease in any complication (adjusted odds ratio 0.89, 95% confidence interval 0.80-0.99) and cost (analysis of variance P < 0.001) but was not associated with readmission, postoperative LOS, or postoperative infection. CONCLUSIONS: Based on a large, contemporary data set from children's hospitals, ketorolac administration in the immediate postoperative period after appendectomy for appendicitis is common and was not associated with an increase in postoperative LOS, postoperative infection, or any-cause 30-d readmission. Ketorolac was, however, independently associated with a lower overall rate of postoperative complications and cost in this population.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/efeitos adversos
Apendicectomia/estatística & dados numéricos
Cetorolaco/efeitos adversos
Complicações Pós-Operatórias/etiologia
[Mh] Termos MeSH secundário: Adolescente
Apendicectomia/efeitos adversos
Criança
Pré-Escolar
Feminino
Seres Humanos
Tempo de Internação
Masculino
Readmissão do Paciente/estatística & dados numéricos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171008
[St] Status:MEDLINE


  4 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28663395
[Au] Autor:Wall PDH; Parsons NR; Parsons H; Achten J; Balasubramanian S; Thompson P; Costa ML; , P. D. H. Wall on behalf of A. P. Sprowson,† M. L. Costa, PAKA Study Group
[Ad] Endereço:Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK .
[Ti] Título:A pragmatic randomised controlled trial comparing the efficacy of a femoral nerve block and periarticular infiltration for early pain relief following total knee arthroplasty.
[So] Source:Bone Joint J;99-B(7):904-911, 2017 07.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this study was to compare the effectiveness of a femoral nerve block and a periarticular infiltration in the management of early post-operative pain after total knee arthroplasty (TKA). PATIENTS AND METHODS: A pragmatic, single centre, two arm parallel group, patient blinded, randomised controlled trial was undertaken. All patients due for TKA were eligible. Exclusion criteria included contraindications to the medications involved in the study and patients with a neurological abnormality of the lower limb. Patients received either a femoral nerve block with 75 mg of 0.25% levobupivacaine hydrochloride around the nerve, or periarticular infiltration with 150 mg of 0.25% levobupivacaine hydrochloride, 10 mg morphine sulphate, 30 mg ketorolac trometamol and 0.25 mg of adrenaline all diluted with 0.9% saline to make a volume of 150 ml. RESULTS: A total of 264 patients were recruited and data from 230 (88%) were available for the primary analysis. Intention-to-treat analysis of the primary outcome measure of a visual analogue score for pain on the first post-operative day, prior to physiotherapy, was similar in both groups. The mean difference was -0.7 (95% confidence interval (CI) -5.9 to 4.5; p = 0.834). The periarticular group used less morphine in the first post-operative day compared with the femoral nerve block group (74%, 95% CI 55 to 99). The femoral nerve block group reported 39 adverse events, of which 27 were serious, in 31 patients and the periarticular group reported 51 adverse events, of which 38 were serious, in 42 patients up to six weeks post-operatively. None of the adverse events were directly attributed to either of the interventions under investigation. CONCLUSION: Periarticular infiltration is a viable and safe alternative to femoral nerve block for the early post-operative relief of pain following TKA. Cite this article: 2017;99-B:904-11.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Anestésicos Locais/administração & dosagem
Anti-Inflamatórios não Esteroides/administração & dosagem
Artroplastia do Joelho
Bupivacaína/análogos & derivados
Nervo Femoral
Cetorolaco/administração & dosagem
Morfina/administração & dosagem
Bloqueio Nervoso/métodos
Manejo da Dor/métodos
Dor Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Bupivacaína/administração & dosagem
Epinefrina/administração & dosagem
Feminino
Seres Humanos
Injeções Intra-Articulares
Masculino
Medição da Dor
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); 0 (Anti-Inflammatory Agents, Non-Steroidal); 76I7G6D29C (Morphine); A5H73K9U3W (levobupivacaine); Y8335394RO (Bupivacaine); YKH834O4BH (Epinephrine); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B7.BJJ-2016-0767.R2


  5 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28574391
[Au] Autor:Gorgiladze T; Nozadze I; Abzianidze E; Tsagareli M
[Ad] Endereço:1Tbilisi State Medical University; 2Beritashvili Center for Experimental Biomedicine, Tbilisi Georgia.
[Ti] Título:NON-STEROIDAL ANTI-INFLAMMATORY DRUGS'S ANTINOCICEPTION MEDIATED BY THE OPIOID MECHANISM IN THE NUCLEUS RAPHE MAGNUS.
[So] Source:Georgian Med News;(265):99-104, 2017 Apr.
[Is] ISSN:1512-0112
[Cp] País de publicação:Georgia (Republic)
[La] Idioma:eng
[Ab] Resumo:It has been established that the midbrain periaqueductal gray matter (PAG) and rostral ventro-medial medulla (RVM) are involved in the descending pain control system. The latter involves the midline nucleus raphe magnus (NRM) and adjacent reticular formation. These brain structures are is one of important parts of CNS circuit that controls nociceptive transmission at the level of spinal cord. Here we report that microinjection of commonly used non-steroidal anti-inflammatory drugs (NSAIDs), diclofenac, ketorolac, metamizol, and xefocam into the NRM produces strong antinociception which is mediated by the opioid mechanism. The experiments were carried out on experimental and control (saline) white albino male rats. Animals were implanted with a guide cannula in the NRM and tested for antinociception following microinjection of NSAIDs into the NRM in the tail flick (TF) and hot plate (HP) tests. The analysis of variance (ANOVA) with post-hoc Tukey-Kramer multiple comparison tests were used for statistical evaluation. The obtained data show that microinjection of these NSAIDs into the NRM produced antinociception as revealed by a latency increase in the tail-flick (TF) and hot plate (HP) latencies compared to the saline control microinjected into the same nucleus. Furthermore, we definitely showed that pre-treatment with opioid antagonist naloxone in the NRM diminishes NSAID-induced antinociception expressing in significant decrease in TF and HP latencies (P<0.001). The present findings support the concept that antinociceptive effects of NSAIDs are mediated via an endogenous opioid system possibly involving the descending pain modulatory circuit.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/farmacologia
Naloxona/farmacologia
Antagonistas de Entorpecentes/farmacologia
Nociceptividade/efeitos dos fármacos
Núcleo Magno da Rafe/efeitos dos fármacos
Peptídeos Opioides/metabolismo
[Mh] Termos MeSH secundário: Animais
Diclofenaco/farmacologia
Dipirona/farmacologia
Cetorolaco/farmacologia
Masculino
Microinjeções
Núcleo Magno da Rafe/fisiologia
Piroxicam/análogos & derivados
Piroxicam/farmacologia
Ratos
Tempo de Reação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Narcotic Antagonists); 0 (Opioid Peptides); 13T4O6VMAM (Piroxicam); 144O8QL0L1 (Diclofenac); 36B82AMQ7N (Naloxone); 6429L0L52Y (Dipyrone); ER09126G7A (lornoxicam); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE


  6 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28526155
[Au] Autor:Vadivelu N; Chang D; Helander EM; Bordelon GJ; Kai A; Kaye AD; Hsu D; Bang D; Julka I
[Ad] Endereço:Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA. Electronic address: Nalini.vadivelu@yale.edu.
[Ti] Título:Ketorolac, Oxymorphone, Tapentadol, and Tramadol: A Comprehensive Review.
[So] Source:Anesthesiol Clin;35(2):e1-e20, 2017 Jun.
[Is] ISSN:1932-2275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pain remains a tremendous burden on patients and for the health care system, with uncontrolled pain being the leading cause of disability in this country. There are a variety of medications that can be used in the treatment of pain, including ketorolac, oxymorphone, tapentadol, and tramadol. Depending on the clinical situation, these drugs can be used as monotherapy or in conjunction with other types of medications in a multimodal approach. A strong appreciation of pharmacologic properties of these agents and potential side effects is warranted for clinicians.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Anti-Inflamatórios não Esteroides/uso terapêutico
Cetorolaco/uso terapêutico
Oximorfona/uso terapêutico
Dor/tratamento farmacológico
Fenóis/uso terapêutico
Tramadol/uso terapêutico
[Mh] Termos MeSH secundário: Analgésicos Opioides/efeitos adversos
Anti-Inflamatórios não Esteroides/efeitos adversos
Seres Humanos
Cetorolaco/efeitos adversos
Oximorfona/efeitos adversos
Medição da Dor
Fenóis/efeitos adversos
Tramadol/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Phenols); 39J1LGJ30J (Tramadol); 9VXA968E0C (Oxymorphone); H8A007M585 (tapentadol); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170521
[St] Status:MEDLINE


  7 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
Texto completo
[PMID]:28516471
[Au] Autor:Wakai A; Lawrenson JG; Lawrenson AL; Wang Y; Brown MD; Quirke M; Ghandour O; McCormick R; Walsh CD; Amayem A; Lang E; Harrison N
[Ad] Endereço:Emergency Care Research Unit (ECRU), Division of Population Health Sciences (PHS), Royal College of Surgeons in Ireland (RCSI), 123 St. Stephen's Green, Dublin 2, Ireland.
[Ti] Título:Topical non-steroidal anti-inflammatory drugs for analgesia in traumatic corneal abrasions.
[So] Source:Cochrane Database Syst Rev;5:CD009781, 2017 05 18.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Traumatic corneal abrasions are relatively common and there is a lack of consensus about analgesia in their management. It is therefore important to document the clinical efficacy and safety profile of topical ophthalmic non-steroidal anti-inflammatory drugs (NSAIDs) in the management of traumatic corneal abrasions. OBJECTIVES: To identify and evaluate all randomised controlled trials (RCTs) comparing the use of topical NSAIDs with placebo or any alternative analgesic interventions in adults with traumatic corneal abrasions (including corneal abrasions arising from foreign body removal), to reduce pain, and its effects on healing time. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 2), MEDLINE Ovid (1946 to 30 March 2017), Embase Ovid (1947 to 30 March 2017), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 30 March 2017), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/); searched 30 March 2017, ZETOC (1993 to 30 March 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 30 March 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 30 March 2017 and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 30 March 2017. We did not use any date or language restrictions in the electronic searches for trials.We checked the reference lists of identified trials to search for further potentially relevant studies. SELECTION CRITERIA: RCTs comparing topical NSAIDs to placebo or any alternative analgesic interventions in adults with traumatic corneal abrasions. DATA COLLECTION AND ANALYSIS: Two review authors independently performed data extraction and assessed risks of bias in the included studies. We rated the certainty of the evidence using GRADE. MAIN RESULTS: We included nine studies that met the inclusion criteria, reporting data on 637 participants.The studies took place in the UK, USA, Israel, Italy, France and Portugal. These studies compared five types of topical NSAIDs (0.1% indomethacin, 0.03% flurbiprofen, 0.5% ketorolac, 1% indomethacin, 0.1% diclofenac) to control (consisting of standard care and in four studies used placebo eye drops). Overall, the studies were at an unclear or high risk of bias (particularly selection and reporting bias). None of the included studies reported the primary outcome measures of this review, namely participant-reported pain intensity reduction of 30% or more or 50% or more at 24 hours. Four trials, that included data on 481 participants receiving NSAIDs or control (placebo/standard care), reported on the use of 'rescue' analgesia at 24 hours as a proxy measure of pain control. Topical NSAIDs were associated with a reduction in the need for oral analgesia compared with control (risk ratio (RR) 0.46, 95% confidence interval (CI) 0.34 to 0.61; low-certainty evidence). Approximately 4 out of 10 people in the control group used rescue analgesia at 24 hours. No data were available on the use of analgesia at 48 or 72 hours.One trial (28 participants) reported on the proportion of abrasions healed after 24 and 48 hours. These outcomes were similar in both arms of the trial. (at 24 hours RR 1.00 (0.81 to 1.23); at 48 hours RR 1.00 (0.88 to 1.14); low-certainty evidence). In the control group nine out of 10 abrasions were healed within 24 hours and all were healed by 48 hours. Complications of corneal abrasions were reported in 6 studies (609 participants) and were infrequently reported (4 complications, 1 in NSAID groups (recurrent corneal erosion) and 3 in control groups (2 recurrent corneal erosions and 1 corneal abscess), very low-certainty evidence). Possible drug-related adverse events (AEs) were reported in two trials (163 participants), with the number of adverse events low (4 AEs, 3 in NSAID group, including discomfort/photophobia on instillation, conjunctival hyperaemia and urticaria, and 1 in the control group, corneal abscess) very low-certainty evidence. AUTHORS' CONCLUSIONS: The findings of the included studies do not provide strong evidence to support the use of topical NSAIDs in traumatic corneal abrasions. This is important, since NSAIDs are associated with a higher cost compared to oral analgesics. None of the trials addressed our primary outcome measure of participant-reported pain intensity reduction of 30% or more or 50% or more at 24 hours.
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/administração & dosagem
Lesões da Córnea/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Tópica
Anti-Inflamatórios não Esteroides/efeitos adversos
Lesões da Córnea/complicações
Diclofenaco/administração & dosagem
Flurbiprofeno/administração & dosagem
Seres Humanos
Indometacina/administração & dosagem
Cetorolaco/administração & dosagem
Medição da Dor
Ensaios Clínicos Controlados Aleatórios como Assunto
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 144O8QL0L1 (Diclofenac); 5GRO578KLP (Flurbiprofen); XXE1CET956 (Indomethacin); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170519
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009781.pub2


  8 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28478713
[Au] Autor:Schwinghammer AJ; Isaacs AN; Benner RW; Freeman H; O'Sullivan JA; Nisly SA
[Ad] Endereço:1 University of California Davis Medical Center, Sacramento, CA, USA.
[Ti] Título:Continuous Infusion Ketorolac for Postoperative Analgesia Following Unilateral Total Knee Arthroplasty.
[So] Source:Ann Pharmacother;51(6):451-456, 2017 Jun.
[Is] ISSN:1542-6270
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Previous clinical trials have demonstrated benefit with the addition of continuous infusion (CI) ketorolac to a multimodal pain regimen in surgical patients. Data following major orthopedic surgery are minimal and conflicting. OBJECTIVES: To evaluate CI ketorolac use following unilateral total knee arthroplasty (TKA) through assessment of patient-reported pain scores, opioid consumption, and safety outcomes. METHODS: This was a retrospective, open-label cohort study that included patients undergoing unilateral TKA at a single-center teaching hospital. Participants were categorized into 2 study groups based on postoperative management: CI ketorolac or opioid protocol (OP). The first group received a ketorolac 30-mg bolus followed by CI 3.6 mg/h plus as-needed (PRN) opioids. The OP group received PRN narcotics in a tiered protocol. The primary end point was comparison of median pain scores. Secondary end points included opioid consumption (morphine equivalent units [MEUs]) in the first 48 hours postoperatively, length of stay, and adverse effects. RESULTS: Of 447 patients screened, 191 were analyzed (CI ketorolac, n = 116; OP, n = 75). Median pain scores were significantly lower in the CI ketorolac group at 48 hours postoperatively (3 [2-4] vs 3.5 [2.5-5], P = 0.033). Cumulative MEUs at 48 hours were significantly lower in the CI ketorolac group (33.9 ± 38.5 mg vs 301.6 ± 36.6 mg, P < 0.001). Patients in the CI ketorolac group experienced less respiratory depression (5.2% vs 25.3%, P < 0.001) and less naloxone administration (0% vs 8%, P = 0.002) compared with the OP group. Other adverse effects were similar among groups. CONCLUSIONS: Postoperative CI ketorolac improved pain control while reducing opioid consumption and adverse effects.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Artroplastia do Joelho/métodos
Cetorolaco/administração & dosagem
Dor Pós-Operatória/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Analgesia/métodos
Analgésicos Opioides/uso terapêutico
Artroplastia do Joelho/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Naloxona/uso terapêutico
Manejo da Dor
Medição da Dor
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 36B82AMQ7N (Naloxone); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE
[do] DOI:10.1177/1060028017694655


  9 / 1307 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28406291
[Au] Autor:Yu Z; Li P; Merz KM
[Ad] Endereço:Department of Chemistry, Michigan State University , East Lansing, Michigan 48824-1322, United States.
[Ti] Título:Using Ligand-Induced Protein Chemical Shift Perturbations To Determine Protein-Ligand Structures.
[So] Source:Biochemistry;56(18):2349-2362, 2017 May 09.
[Is] ISSN:1520-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Protein chemical shift perturbations (CSPs), upon ligand binding, can be used to refine the structure of a protein-ligand complex by comparing experimental CSPs with calculated CSPs for any given set of structural coordinates. Herein, we describe a fast and accurate methodology that opens up new opportunities for improving the quality of protein-ligand complexes using nuclear magnetic resonance (NMR)-based approaches by focusing on the effect of the ligand on the protein. The new computational approach, H empirical chemical shift perturbation (HECSP), has been developed to rapidly calculate ligand binding-induced H CSPs in a protein. Given the dearth of experimental information by which a model could be derived, we employed high-quality density functional theory (DFT) computations using the automated fragmentation quantum mechanics/molecular mechanics approach to derive a database of ligand-induced CSPs on a series of protein-ligand complexes. Overall, the empirical HECSP model yielded correlation coefficients between its predicted and DFT-computed values of 0.897 ( HA), 0.971 ( HN), and 0.945 (side chain H) with root-mean-square errors of 0.151 ( HA), 0.199 ( HN), and 0.257 ppm (side chain H), respectively. Using the HECSP model, we developed a scoring function (NMRScore_P). We describe two applications of NMRScore_P on two complex systems and demonstrate that the method can distinguish native ligand poses from decoys and refine protein-ligand complex structures. We provide further refined models for both complexes, which satisfy the observed H CSPs in experiments. In conclusion, HECSP coupled with NMRScore_P provides an accurate and rapid platform by which protein-ligand complexes can be refined using NMR-derived information.
[Mh] Termos MeSH primário: Naftalenossulfonato de Anilina/química
Anti-Inflamatórios não Esteroides/química
Proteínas de Ligação a Ácido Graxo/química
Cetorolaco/química
Espectroscopia de Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Sítios de Ligação
Seres Humanos
Ligantes
Simulação de Acoplamento Molecular
Ligação Proteica
Conformação Proteica em alfa-Hélice
Conformação Proteica em Folha beta
Domínios Proteicos
Projetos de Pesquisa
Termodinâmica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (8-anilino-1-naphthalenesulfonic acid); 0 (Anilino Naphthalenesulfonates); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Fatty Acid-Binding Proteins); 0 (Ligands); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1021/acs.biochem.7b00170


  10 / 1307 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28392176
[Au] Autor:Campochiaro PA; Han YS; Mir TA; Kherani S; Hafiz G; Krispel C; Liu TYA; Wang J; Scott AW; Zimmer-Galler I
[Ad] Endereço:The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland. Electronic address: pcampo@jhmi.edu.
[Ti] Título:Increased Frequency of Topical Steroids Provides Benefit in Patients With Recalcitrant Postsurgical Macular Edema.
[So] Source:Am J Ophthalmol;178:163-175, 2017 Jun.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare standard and frequent topical steroids for postsurgical macular edema (ME). DESIGN: Randomized clinical trial. METHODS: Subjects with postsurgical ME stratified into post-cataract surgery ME (PCSME) and post-other surgery ME (POSME) were randomized to ketorolac 4 times a day (qid) + 1% prednisolone acetate (PA) every hour while awake (q1hWA, Group 1) or qid (Group 2). Mean change from baseline best-corrected visual acuity (BCVA) was determined at week 12, after which group 2 subjects with persistent edema were crossed over to PA q1hWA. RESULTS: Twenty-two subjects (13 PCSME and 9 POSME) were randomized to Group 1 and 20 (12 PCSME and 8 POSME) to Group 2. At week 12, change from baseline BCVA (ETDRS letters) in Group 1 vs 2 was +11.6 vs +8.5 (P = .32) and for subgroups was +10.6 vs +7.8 (P = .23) for PCSME and +13.1 vs +9.4 (P = .47) for POSME. Mean change from baseline central subfield thickness (CST, µm) at week 12 in Group 1 vs 2 was -100.8 vs -63.9 (P = .30). Mean change from baseline intraocular pressure was +2.6 vs +1.7 mm Hg (P = .52). Eight subjects in Group 2 with residual ME at week 12 were switched to PA q1hWA and at week 24, the mean changes from week 12 BCVA and CST were +7.0 letters (P = .01) and -108.25 µm (P = .04). CONCLUSIONS: Our data suggest that patients with postsurgical ME should initially be treated with ketorolac and PA qid, but if edema does not resolve after 12 weeks, a switch to ketorolac qid and PA q1hWA may provide benefit.
[Mh] Termos MeSH primário: Extração de Catarata/efeitos adversos
Glucocorticoides/administração & dosagem
Edema Macular/tratamento farmacológico
Complicações Pós-Operatórias
Prednisolona/análogos & derivados
Acuidade Visual
[Mh] Termos MeSH secundário: Administração Tópica
Idoso
Anti-Inflamatórios não Esteroides/administração & dosagem
Relação Dose-Resposta a Droga
Esquema de Medicação
Feminino
Seguimentos
Seres Humanos
Cetorolaco/administração & dosagem
Macula Lutea/patologia
Edema Macular/diagnóstico
Edema Macular/etiologia
Masculino
Meia-Idade
Prednisolona/administração & dosagem
Pró-Fármacos
Tomografia de Coerência Óptica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Glucocorticoids); 0 (Prodrugs); 8B2807733D (prednisolone acetate); 9PHQ9Y1OLM (Prednisolone); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE



página 1 de 131 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde