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Changes in Streptococcus pneumoniae Susceptibility in Wisconsin: Implications for Clinical Treatment Decisions for Respiratory Infections. 威斯康星州肺炎链球菌易感性的变化:对呼吸道感染临床治疗决策的影响。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-12-01 DOI: 10.3121/cmr.2022.1767
Erik Munson, Stephen C Lavey, Megan R Lasure, Barry C Fox
{"title":"Changes in <i>Streptococcus pneumoniae</i> Susceptibility in Wisconsin: Implications for Clinical Treatment Decisions for Respiratory Infections.","authors":"Erik Munson,&nbsp;Stephen C Lavey,&nbsp;Megan R Lasure,&nbsp;Barry C Fox","doi":"10.3121/cmr.2022.1767","DOIUrl":"https://doi.org/10.3121/cmr.2022.1767","url":null,"abstract":"<p><p><b>Objective:</b> In 2019, the American Thoracic Society and Infectious Diseases Society of America updated clinical practice guidelines for community-acquired pneumonia (CAP). In contrast to guidelines published in 2007, macrolide monotherapy for outpatients was made a conditional recommendation based on resistance levels. Local knowledge of current antimicrobial susceptibility is needed to guide management of CAP and other bacterial respiratory pathogens. The purpose of this study was to investigate antimicrobial susceptibility profiles and trending for Wisconsin <i>Streptococcus pneumoniae</i> isolates.<b>Design:</b> Multi-center laboratory surveillance, with testing at a central location utilizing standardized susceptibility testing protocols.<b>Methods:</b> Data published by the Wisconsin Department of Health Services (DHS) were augmented with data from the Surveillance of Wisconsin Organisms for Trends in Antimicrobial Resistance and Epidemiology (SWOTARE) program. Data were stratified by invasive or non-invasive sources, as well as DHS region and compared to data compiled from 2006-2010.<b>Results:</b> Susceptibility rates for ≥ 916 invasive <i>S. pneumoniae</i> assessed from 2016-2020 were greater than 91% for ceftriaxone, tetracycline, and fluoroquinolone agents and were generally higher than those from 354 non-invasive isolates. Low susceptibility rates were observed for invasive isolates of penicillin (78.7%) and erythromycin (64.8%) and were even lower for non-invasive isolates (73.8% and 59.9%, respectively). This erythromycin susceptibility rate was a significant reduction from that observed in 2006-2010 (80.4; <i>P</i> < 0.0002). 24.8% of isolates generated an erythromycin MIC ≥ 8 μg/mL. Statewide geographic variability was noted.<b>Conclusions:</b> Rates of <i>S. pneumoniae</i> susceptibility to parenteral penicillins and cephems, and oral tetracycline and fluoroquinolone agents, remain high throughout Wisconsin. However, low oral penicillin susceptibility rates, taken together with declining macrolide susceptibility rates, should cause clinicians to consider alternative treatment options for respiratory tract infections, especially with macrolides.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"20 4","pages":"185-194"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799222/pdf/0200185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Plasma Brain-Derived Neurotrophic Factor and Opioid Therapy: Results of Pilot Cross-Sectional Study. 血浆脑源性神经营养因子和阿片类药物治疗:试点横断面研究的结果。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-12-01 DOI: 10.3121/cmr.2022.1731
Ursula Kosciuczuk, Piotr Jakubow, Jolanta Czyzewska, Pawel Knapp, Ewa Rynkiewicz-Szczepanska
{"title":"Plasma Brain-Derived Neurotrophic Factor and Opioid Therapy: Results of Pilot Cross-Sectional Study.","authors":"Ursula Kosciuczuk,&nbsp;Piotr Jakubow,&nbsp;Jolanta Czyzewska,&nbsp;Pawel Knapp,&nbsp;Ewa Rynkiewicz-Szczepanska","doi":"10.3121/cmr.2022.1731","DOIUrl":"https://doi.org/10.3121/cmr.2022.1731","url":null,"abstract":"<p><p><b>Objective:</b> The neurotoxic effect of opioid has not been thoroughly described. No studies have been conducted to explain the effect of opioids in chronic non-cancer pain therapy on the neurotrophic factors level. Due to the ability to cross the blood-brain barrier, it seems the determination of serum Brain-derived neurotrophic factor (BDNF) concentration is a reliable presentation of the concentration in the central nervous system. The aim of the study was to explore the changes of plasma BDNF concentration during long-term opioid therapy.<b>Methods:</b> The study group included 28 patients with chronic low back pain treated with opioid therapy buprenorphine (n=10), tramadol (n=8), oxycodone (n=6), morphine (n=3), fentanyl (n=1). The control group included 11 patients. Measurements of plasma BDNF concentrations were performed, and information about opioid therapy were recorded (age, sex, opioid substance type, daily dose and the duration of opioid therapy). Data were analyzed using nonparametric tests.<b>Results:</b> The median BDNF level in the study group was significantly lower (2.73 ng/mL) than that in the control group (5.04 ng/mL, <i>P</i><0.05). BDNF levels did not differ among groups based on the type of opioid substance used, but the lowest median value was observed for tramadol (2.62 ng/mL), and the highest median value was observed for buprenorphine (2.73 ng/mL). The widest minimum-maximum ranges of BDNF for oxycodone were noted, minimum 1.23 ng/mL and maximum 4.57 ng/mL, respectively. BDNF concentrations were correlated with age in the tramadol group and with the duration of opioid therapy in the buprenorphine group.<b>Conclusion:</b> Chronic opioid therapy for noncancer pain induces specific changes in the BDNF concentration. Tramadol and buprenorphine exerted an important effect on BDNF levels in the examined patients. The BDNF level depends on duration of opioid therapy with buprenorphine, and age in tramadol therapy.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"20 4","pages":"195-203"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799226/pdf/0200195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disease Staging: Prevalence of Cardiorespiratory Complications in Type 2 Diabetes Mellitus. 疾病分期:2型糖尿病患者心肺并发症的患病率
IF 1.4
Clinical Medicine & Research Pub Date : 2022-12-01 DOI: 10.3121/cmr.2022.1699
Maria Cristina Carrondo
{"title":"Disease Staging: Prevalence of Cardiorespiratory Complications in Type 2 Diabetes Mellitus.","authors":"Maria Cristina Carrondo","doi":"10.3121/cmr.2022.1699","DOIUrl":"https://doi.org/10.3121/cmr.2022.1699","url":null,"abstract":"<p><p><b>Introduction:</b> The incidence of cardiorespiratory complications in diabetic patients is a major concern for healthcare organizations and providers in Portugal. The objectives of this study were (1) to study the prevalence of cardiorespiratory complications during hospitalization in the diabetic population and (2) to identify their associated factors.<b>Methods:</b> This is a cross-sectional study and included 7,347 diabetic patients admitted to all specialty services enrolled between January 1, 2018 and December 31, 2018 in 32 public hospitals in Portugal. Hospital discharge summary data and both Disease-Related Diagnosis Groups and Disease Staging were used. Descriptive statistical analysis was used where the distribution and rates of cardiorespiratory complications were calculated. Logistic regression using the risk adjustment model was used to calculate the associated risk factors for cardiorespiratory complications.<b>Results:</b> The total rate of cardiorespiratory complications was 18.2% cardiorespiratory complications; in women it was 21.5% and in men 15.6%. The comorbidity of congestive heart failure (98.0%) was significantly higher (<i>P</i><0.001) among patients undergoing medical treatment, and the comorbidities bacterial pneumonia and coronary artery disease without prior coronary revascularization were significantly higher (63.9%, 45.1%, and 33.4%, <i>P</i><0.001).<b>Discussion:</b> The use of different therapies to control glucose levels and the absence of antibiotic prophylaxis during medical treatment may account for these data.<b>Conclusions:</b> Cardiorespiratory complications were higher in women than in men and in those who received medical treatment. Comorbidities such as congestive heart failure, such as bacterial pneumonia and coronary artery disease without prior coronary revascularization were identified as risk factors.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"20 4","pages":"204-210"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799228/pdf/0200204.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac Involvement and Absence of Asthma – What is Phenotype Specificity of EGPA: A Case Report 心脏受累和不存在哮喘-什么是EGPA的表型特异性:一个病例报告
IF 1.4
Clinical Medicine & Research Pub Date : 2022-09-01 DOI: 10.3121/cmr.2022.1683
J. Fijołek, E. Wiatr, K. Błasińska, D. Piotrowska-Kownacka, K. Roszkowski-Śliż
{"title":"Cardiac Involvement and Absence of Asthma – What is Phenotype Specificity of EGPA: A Case Report","authors":"J. Fijołek, E. Wiatr, K. Błasińska, D. Piotrowska-Kownacka, K. Roszkowski-Śliż","doi":"10.3121/cmr.2022.1683","DOIUrl":"https://doi.org/10.3121/cmr.2022.1683","url":null,"abstract":"Eosinophilic granulomatosis with polyangiitis (EGPA) typically is characterized by asthma, blood eosinophilia, and extrapulmonary manifestations. Asthma is a major EGPA symptom affecting almost all patients, but cardiac involvement is one of the most serious manifestations, responsible for 31% of deaths. Two recently defined phenotypes of EGPA, according to the patient’s antineutrophil cytoplasmic antibody (ANCA) status, differ significantly in clinical features and prognosis. We share a case of EGPA characterized by atypical manifestation without any evidence of asthma, in whom extensive cardiac involvement was the dominant manifestation of vasculitis. This case demonstrates the difficulties associated with phenotyping EGPA and highlights the importance of cardiac magnetic resonance imaging (CMRI) in definitive diagnosis.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"2 1","pages":"170 - 176"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86992190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
A Review of the Efficacy of Therapeutic Maneuvers in Posterior Canal Benign Paroxysmal Positional Vertigo 手法治疗后管良性阵发性位置性眩晕的疗效综述
IF 1.4
Clinical Medicine & Research Pub Date : 2022-09-01 DOI: 10.3121/cmr.2022.1686
S. Yetişer, Z. Salturk
{"title":"A Review of the Efficacy of Therapeutic Maneuvers in Posterior Canal Benign Paroxysmal Positional Vertigo","authors":"S. Yetişer, Z. Salturk","doi":"10.3121/cmr.2022.1686","DOIUrl":"https://doi.org/10.3121/cmr.2022.1686","url":null,"abstract":"Benign paroxysmal positional vertigo (BPPV) is associated with significant functional impairment with the change of head position with respect to gravity. Therapeutic maneuvers provide relief of symptoms; however, some patients may have persistent symptoms and can be significantly disabled. The aim of this study is to review the critical factors that may have an impact on outcome. Six main categories that may possibly affect the outcome of therapeutic maneuvers in patients with posterior canal (PC) BPPV were selected. A review of the 1095 articles on therapeutic maneuvers in patients with PC BPPV was conducted by means of a search in PubMed, Embase, and Scopus databases between 1989 and 2020. We documented 14 articles about the comparative analysis of success rate of Semont and Epley maneuvers, 7 articles about the comparative analysis of success rate of therapeutic maneuvers and no treatment or sham maneuver, 7 articles about the comparison of success rate in treatment of traumatic and idiopathic cases, 12 articles about the comparison of outcome of repositioning maneuvers with or without postural restrictions, 12 articles about the comparison of success rate of medication and therapeutic maneuvers, and 9 articles about the comparison of vestibular exercises and therapeutic maneuvers. In conclusion, therapeutic maneuvers provide better outcome as compared to no treatment or sham maneuver. Epley maneuver has greater success rate than Semont maneuver. Traumatic cases are prone to develop more recurrences than idiopathic cases and have lower rate of symptom resolution. Body restrictions following successful repositioning maneuver has no impact on recurrence. Medical therapy or vestibular exercise alone is not an alternative to therapeutic maneuvers. However, the rate of residual dizziness is low when the vestibular exercises are combined.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"44 1","pages":"153 - 163"},"PeriodicalIF":1.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73937191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Extended Tourniquet Times and the Impact on Wound Healing in Foot Surgery. 延长止血带时间及其对足部手术伤口愈合的影响。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-08-26 DOI: 10.3121/cmr.2022.1668
Callum Robertson, Victoria Wilson, R M Dominic Meek, Robert Carter
{"title":"Extended Tourniquet Times and the Impact on Wound Healing in Foot Surgery.","authors":"Callum Robertson, Victoria Wilson, R M Dominic Meek, Robert Carter","doi":"10.3121/cmr.2022.1668","DOIUrl":"10.3121/cmr.2022.1668","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare the effect of tourniquet time less than or in excess of 120 minutes on foot surgery wound healing.</p><p><strong>Null hypothesis: </strong>A tourniquet time of over 120 minutes will not affect wound healing in foot surgery.</p><p><strong>Design, setting, participants and method: </strong>A retrospective comparative cohort analysis was performed on 96 patients undergoing complex hindfoot surgery in a large central teaching hospital. Fifty-five patients receiving tourniquet pressure for >120 minutes and 41 receiving <120 minutes of tourniquet pressure were identified from electronic case records. The primary outcome was surgical wound healing. Secondary outcomes were discharge date and complication rate.</p><p><strong>Results: </strong>There was no significant difference in reported time for wounds to heal in the <120-minute or >120-minute cohort. There were no other significant differences in secondary clinical outcomes and no significant variations in patient demographics.</p><p><strong>Conclusion: </strong>This study suggests that tourniquet times from 2 to 3 hours in foot and ankle surgery with pressures up to 300 mmHg are not associated with a significant effect on wound healing.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544197/pdf/0200141.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10460081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anthropometric Measures for the Prognosis of Obstructive Sleep Apnea in Obese. 用于预测肥胖症患者阻塞性睡眠呼吸暂停的人体测量指标。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-08-26 DOI: 10.3121/cmr.2022.1679
Laura Souza Lagares, Ramon Souza Lino, Eric Simas Bomfim, Felipe Almeida Santos, Ciro Oliveira Queiroz, Lélia Lessa Pinto, Luiz Alberto Bastos Almeida, Clarcson Plácido Santos
{"title":"Anthropometric Measures for the Prognosis of Obstructive Sleep Apnea in Obese.","authors":"Laura Souza Lagares, Ramon Souza Lino, Eric Simas Bomfim, Felipe Almeida Santos, Ciro Oliveira Queiroz, Lélia Lessa Pinto, Luiz Alberto Bastos Almeida, Clarcson Plácido Santos","doi":"10.3121/cmr.2022.1679","DOIUrl":"10.3121/cmr.2022.1679","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to identify, among the different anthropometric indicators, the one that shows higher discriminatory power for the prognosis of Obstructive Sleep Apnea Syndrome (OSAS).</p><p><strong>Design: </strong>Observational cross-sectional study PARTICIPANTS: Obese individuals elective to bariatric surgery METHODS: A study based on data of 758 patients aged ≥ 21 years old, of both sexes, in the pre-operatory stage of the surgical procedure of gastric bypass. Obstructive sleep apnea and obstructive sleep hypopnea were evaluated and classified through the apnea-hypopnea index, which was obtained through the examination of polysomnography. Variables were divided into two groups: individuals with and without OSAS. As predictors, measures of body mass index (BMI), neck circumference (NC), and waist circumference (WC) were used.</p><p><strong>Results: </strong>The area under the ROC curve was used to check the sensitivity and specificity. All evaluated anthropometric indicators showed statistical significance. WC: area of 0.62 (CI 95%: 0.58 - 0.67), NC: area of 0,68 (CI 95%: 0.64 - 0.72) and BMI: area of 0.58 (CI 95%: 0.54 - 0.63).</p><p><strong>Conclusion: </strong>The investigated anthropometric indicators performed as good predictors of OSAS. However, NC seems to be the best anthropometric indicator for the prognosis of OSAS in obese individuals when compared to BMI and WC.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544195/pdf/0200147.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10460080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Extended Tourniquet Times and the Impact on Wound Healing in Foot Surgery 延长止血带次数及对足部手术伤口愈合的影响
IF 1.4
Clinical Medicine & Research Pub Date : 2022-08-26 DOI: 10.3121/cmr.2022/1668
Callum Robertson, V. Wilson, R. Meek, R. Carter
{"title":"Extended Tourniquet Times and the Impact on Wound Healing in Foot Surgery","authors":"Callum Robertson, V. Wilson, R. Meek, R. Carter","doi":"10.3121/cmr.2022/1668","DOIUrl":"https://doi.org/10.3121/cmr.2022/1668","url":null,"abstract":"Objective: The aim of this study was to compare the effect of tourniquet time less than or in excess of 120 minutes on foot surgery wound healing. Null hypothesis: A tourniquet time of over 120 minutes will not affect wound healing in foot surgery. Design, Setting, Participants and Method: A retrospective comparative cohort analysis was performed on 96 patients undergoing complex hindfoot surgery in a large central teaching hospital. Fifty-five patients receiving tourniquet pressure for >120 minutes and 41 receiving <120 minutes of tourniquet pressure were identified from electronic case records. The primary outcome was surgical wound healing. Secondary outcomes were discharge date and complication rate. Results: There was no significant difference in reported time for wounds to heal in the <120-minute or >120-minute cohort. There were no other significant differences in secondary clinical outcomes and no significant variations in patient demographics. Conclusion: This study suggests that tourniquet times from 2 to 3 hours in foot and ankle surgery with pressures up to 300 mmHg are not associated with a significant effect on wound healing.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"62 1","pages":"141 - 146"},"PeriodicalIF":1.4,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88353309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Meperidine-Ketorolac Combination Provides Better Analgesia than Meperidine Alone in Postoperative Patients. 甲哌啶-酮咯酸复方制剂为术后患者提供的镇痛效果优于单用甲哌啶。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-08-23 DOI: 10.3121/cmr.2022.1628
Nelly N Umukoro, Shola S Jamgbadi, Erdoo S Isamade
{"title":"Meperidine-Ketorolac Combination Provides Better Analgesia than Meperidine Alone in Postoperative Patients.","authors":"Nelly N Umukoro, Shola S Jamgbadi, Erdoo S Isamade","doi":"10.3121/cmr.2022.1628","DOIUrl":"10.3121/cmr.2022.1628","url":null,"abstract":"<p><strong>Background: </strong>Our study objective was to assess if multi-modal analgesia with meperidine-ketorolac combination provides superior analgesia or reduces opioid requirement following surgery compared to Meperidine alone.</p><p><strong>Design: </strong>Double-blind randomized controlled trial.</p><p><strong>Setting: </strong>Postoperative pain control in orthopedic ward after spinal anesthesia.</p><p><strong>Patients: </strong>American Society of Anesthesiology (ASA) risk I or II (ASA I/II) patients who had lower limb implant surgery (88) at our center from September 2014 to July 2015.</p><p><strong>Interventions: </strong>Patients were randomly assigned to receive either 1 mg/kg of intravenous (IV) meperidine and 30 mg of IV ketorolac (treatment group) or 1 mg/kg of IV meperidine (control group) post-surgery, administered every hour for the first 6 hours during the first 24 hours post-surgery. In addition, patients received intravenous meperidine on an 'as needed basis' during the first 24 hours of the postoperative period.</p><p><strong>Measurements: </strong>Outcomes were time-to-first analgesia request postoperatively; cumulative opioid dose in first 24 hours post-surgery; frequency of side effects; and patient satisfaction with pain relief using a Likert scale. Numerical rating scale (NRS) pain scores hourly for the first 6 hours, then the 8th, 12th, 16th, 18th and 24th hour post-surgery were assessed.</p><p><strong>Results: </strong>There was a significant delay in time of first request for analgesia (460 min vs 225 min; <i>P</i>=0.03) and a reduction in opioid consumption in 24 hours (299 mg vs 325 mg; <i>P</i>=0.01) in the meperidine/ketorolac group compared with the meperidine alone group which were both statistically significant. Patient satisfaction with pain relief was better in the treatment group (<i>P</i>=0.01). Additionally, there were fewer side effects in the treatment group than in the control group but this was not statistically significant.</p><p><strong>Conclusions: </strong>Adding ketorolac to meperidine reduced postoperative pain, reduced patient daily opioid requirement, increased patient satisfaction with pain relief, without increasing the frequency of side effects. Therefore, IV ketorolac addition to opioids may be a reasonable option in multimodal analgesic protocol.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544193/pdf/0200133.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10455929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effectiveness of Oral Immunotherapy in Patients with Sesame Anaphylaxis using Omalizumab. 使用奥马珠单抗对芝麻过敏性休克患者进行口服免疫疗法的效果。
IF 1.4
Clinical Medicine & Research Pub Date : 2022-08-23 DOI: 10.3121/cmr.2022.1730
Fereshteh Salari, Mohammad Hassan Bemanian, Morteza Fallahpour, Seyed Alireza Mahdaviani, Sima Shokri, Majid Khoshmirsafa, Farhad Seif, Mohammad Nabavi, Saba Arshi
{"title":"The Effectiveness of Oral Immunotherapy in Patients with Sesame Anaphylaxis using Omalizumab.","authors":"Fereshteh Salari, Mohammad Hassan Bemanian, Morteza Fallahpour, Seyed Alireza Mahdaviani, Sima Shokri, Majid Khoshmirsafa, Farhad Seif, Mohammad Nabavi, Saba Arshi","doi":"10.3121/cmr.2022.1730","DOIUrl":"10.3121/cmr.2022.1730","url":null,"abstract":"<p><strong>Objective: </strong>Sesame allergy is the most prevalent allergy to seeds. Oral immunotherapy (OIT) is defined as continuous consumption of an allergen at special doses and time. Omalizumab (Anti-IgE) increases tolerance to allergens used in OIT. This study evaluated the effectiveness of a new sesame OIT protocol in patients with sesame anaphylaxis in combination with omalizumab.</p><p><strong>Methods: </strong>In this prospective open-label interventional trial study, 11 patients with a history of sesame anaphylaxis were enrolled after confirmation by oral food challenge (OFC) test. At baseline, skin prick test (SPT) and skin prick to prick (SPP) test were performed. Serum sesame-specific IgE (sIgE) levels were measured. The maintenance phase was continued at home with daily sesame intake for 4 months. At the end of month 4, the OFC and above-mentioned tests were repeated to evaluate the treatment effectiveness.</p><p><strong>Results: </strong>All 11 patients who underwent sesame OIT after 4 months could tolerate a dietary challenge of 22 ml tahini (natural sesame seed, equal to 5,000 mg of sesame protein and higher) and the average of wheal diameter in the SPT and SPP tests significantly decreased after desensitization.</p><p><strong>Conclusion: </strong>This OIT protocol may be a promising desensitization strategy for patients with sesame anaphylaxis. Also, omalizumab appears to have reduced the severity of reactions.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9544196/pdf/0200125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10455931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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