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https://www.readbyqxmd.com/read/28214970/optimal-bowel-cleansing-for-colonoscopy-in-the-elderly-patient
#1
Samuel B Ho, Rita Hovsepians, Samir Gupta
Colonoscopy is an important diagnostic and screening tool for colorectal cancer detection and prevention, and adequate bowel preparation is critical for successful colonoscopy. Complications related to colonoscopy, either directly or indirectly related to the procedure, are increased in elderly patients, and the risks and benefits of colonoscopy procedures need to be carefully considered in these patients. Recent studies have shown that 4 L polyethylene glycol with a split preparation is safe and effective for elderly patients, and is the preferred preparation for patients with medical comorbidities...
February 18, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28214943/comparison-of-mesh-fixation-and-non-fixation-in-laparoscopic-totally-extraperitoneal-inguinal-hernia-repair
#2
K Buyukasik, A Ari, B Akce, C Tatar, O Segmen, H Bektas
PURPOSE: The purpose of this study was to compare laparoscopic total extraperitoneal (TEP) hernia repair procedures with or without mesh fixation for non-recurrent inguinal hernia. METHODS: 100 male patients with non-recurrent inguinal hernia (62 unilateral and 38 bilateral) were included in the study. The patients were randomly assigned to either the mesh fixation group (n = 50) or the mesh non-fixation group (n = 50). The operative and follow-up data of the two groups were analyzed and compared in terms of recurrence rates, postoperative pain, length of hospital stay, and postoperative changes in testicular arterial blood flow...
February 18, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28211545/the-effect-of-gut-microbiome-on-tolerance-to-morphine-mediated-antinociception-in-mice
#3
Minho Kang, Ryan A Mischel, Sukhada Bhave, Essie Komla, Alvin Cho, Charity Huang, William L Dewey, Hamid I Akbarali
There is growing appreciation for the importance of gastrointestinal microbiota in many physiological and pathophysiological processes. While morphine and other narcotics are the most widely prescribed therapy for moderate to severe pain clinically, they have been noted to alter microbial composition and promote bacterial translocation to other tissues. Here we examined the pharmacodynamic properties of chronic morphine in mice following bacterial depletion with oral gavage of an antibiotic cocktail (ABX). ABX significantly reduced gut bacteria and prevented chronic morphine induced increases in gut permeability, colonic mucosal destruction, and colonic IL-1β expression...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28210646/pain-assessment-after-anterior-cruciate-ligament-reconstruction-bone-patellar-tendon-bone-versus-hamstring-tendon-autograft
#4
Kelechi R Okoroha, Robert A Keller, Edward K Jung, Lafi Khalil, Nathan Marshall, Patricia A Kolowich, Vasilios Moutzouros
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is a common outpatient procedure that is accompanied by significant postoperative pain. PURPOSE: To determine differences in acute pain levels between patients undergoing ACL reconstruction with bone-patellar tendon-bone (BTB) versus hamstring tendon (HS) autograft. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 70 patients who underwent primary ACL reconstruction using either BTB or HS autografts consented to participate...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210502/a-single-perioperative-injection-of-dexamethasone-decreases-nausea-vomiting-and-pain-after-laparoscopic-donor-nephrectomy
#5
Shigeyoshi Yamanaga, Andrew Mark Posselt, Chris Earl Freise, Takaaki Kobayashi, Mehdi Tavakol, Sang-Mo Kang
Background. A single dose of perioperative dexamethasone (8-10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4-6 mg)  (n = 70) or a higher dose (8-14 mg) of dexamethasone (n = 100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching...
2017: Journal of Transplantation
https://www.readbyqxmd.com/read/28208284/detection-of-papaverine-for-the-possible-identification-of-illicit-opium-cultivation
#6
Rustin Y Mirsafavi, Kristine Lai, Neal D Kline, Augustus W Fountain, Carl D Meinhart, Martin Moskovits
Papaverine is a non-narcotic alkaloid found endemically and uniquely in the latex of the opium poppy. It is normally refined out of the opioids that the latex is typically collected for, hence its presence in a sample is strong prima facie evidence that the carrier from whom the sample was collected is implicated in the mass cultivation of poppies or the collection and handling of their latex. We describe an analysis technique combining surface-enhanced Raman spectroscopy (SERS) with microfluidics for detecting papaverine at low concentrations and show that its SERS spectrum has unique spectroscopic features that allows its detection at low concentrations among typical opioids...
February 7, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28204979/one-year-swallowing-outcomes-in-patients-treated-with-prophylactic-gabapentin-during-radiation-based-treatment-for-oropharyngeal-cancer
#7
Heather M Starmer, WuYang Yang, Christine G Gourin, Rachit Kumar, Bronwyn Jones, Todd McNutt, Sierra Cheng, Harry Quon
Recent investigations by our study team have demonstrated patients using gabapentin for pain management during chemoradiotherapy (CRT) do well maintaining swallowing during treatment with less need for narcotic pain medication, PEG dependence, weight loss, and short-term swallowing morbidity. The purpose of this investigation was to characterize the long-term swallowing function of these patients 1-year following treatment. Sequential patients receiving CRT for oropharyngeal cancer and concurrent gabapentin were evaluated 1-year following treatment for swallowing outcomes...
February 15, 2017: Dysphagia
https://www.readbyqxmd.com/read/28203561/comparative-prospective-case-control-study-of-open-versus-laparoscopic-pyeloplasty-in-children-with-ureteropelvic-junction-obstruction-long-term-results
#8
Lisandro A Piaggio, Juan P Corbetta, Santiago Weller, Ricardo Augusto Dingevan, Víctor Duran, Javier Ruiz, Juan C Lopez
INTRODUCTION: We compare open pyeloplasty (OP) versus laparoscopic pyeloplasty (LP) in children in a multicenter, prospective, case-control study. MATERIALS AND METHODS: From May 2007 to March 2009, a program was established at Hospital Garrahan, the reference center, to perform LP with a mentoring surgeon that would attend the institution once a month. Every new case of ureteropelvic junction obstruction (UPJO) diagnosed in the reference institution was offered to participate in the study...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28202930/harm-reduction-and-e-cigarettes-distorting-the-approach
#9
Michael Moore, Martin McKee, Mike Daube
Some supporters of electronic cigarettes have argued that they should be considered a form of harm reduction, analogous to that which has been successful with narcotics. In this viewpoint, we contend that this argument is based on highly selective use of the evidence, coupled with a fundamental misunderstanding of a comprehensive harm minimisation strategy. This includes not only harm reduction but also reduction in demand and supply-two elements that are explicitly rejected by many advocates of electronic cigarettes...
December 2016: Journal of Public Health Policy
https://www.readbyqxmd.com/read/28191368/a-rare-case-of-adult-onset-intussusception-complicated-by-narcotic-dependence
#10
Saira J Khan, Ashley M Desmarais, Bellal Joseph, Richard Amini
This report describes a rare case of adult intussusception in a patient with a history of a Roux-en-Y gastric bypass procedure; complicated by a history of narcotic abuse, methadone dependence, and methamphetamine abuse. Adult patients who have undergone a Roux-en-Y gastric bypass procedure may be at an increased risk of developing intussusception, and clinicians involved in their care should be aware of this potential complication.
January 8, 2017: Curēus
https://www.readbyqxmd.com/read/28190433/seizures-in-the-critically-ill
#11
J Ch'ang, J Claassen
Critically ill patients with seizures are either admitted to the intensive care unit because of uncontrolled seizures requiring aggressive treatment or are admitted for other reasons and develop seizures secondarily. These patients may have multiorgan failure and severe metabolic and electrolyte disarrangements, and may require complex medication regimens and interventions. Seizures can be seen as a result of an acute systemic illness, a primary neurologic pathology, or a medication side-effect and can present in a wide array of symptoms from convulsive activity, subtle twitching, to lethargy...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28185289/effect-of-epidural-compared-to-patient-controlled-intravenous-analgesia-on-outcomes-for-patients-undergoing-liver-resection-for-neoplastic-disease
#12
Shelby Allen, Amy DeRoche, Lu Adams, Karen Valerie Slocum, Clancy J Clark, Nora F Fino, Perry Shen
BACKGROUND: Epidural analgesia is routinely used for postoperative pain control following abdominal surgeries, yet data regarding the safety and efficacy of epidural analgesia is controversial. METHODS: Pain-related and clinical perioperative data were extracted and correlated with baseline clinicopathologic data and method of analgesia (epidural vs. intravenous patient-controlled analgesia) in patients who underwent hepatectomy from 2012 to 2014. Chronic pain was defined by specific narcotic requirements preoperatively...
February 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28175145/p415-trends-in-narcotic-and-corticosteroid-prescriptions-in-patients-with-inflammatory-bowel-disease-in-the-united-states-ambulatory-care-setting-from-2003-to-2011
#13
N Narula, L Borges, A H Steinhart, J-F Colombel
No abstract text is available yet for this article.
February 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28164777/is-celecoxib-a-useful-adjunct-in-the-treatment-of-post-tonsillectomy-pain-in-the-adult-population-a-randomised-double-blind-placebo-controlled-study
#14
RANDOMIZED CONTROLLED TRIAL
T-T Ng, D Diamantaras, J Priestley, J Redman, N De Silva, V Mahanta
OBJECTIVE: To evaluate the efficacy and safety of celecoxib for pain management in post-tonsillectomy adult patients. DESIGN: A randomised, double-blind, placebo-controlled, phase 3 clinical trial was conducted in an adult population (aged 18-55 years), with a parallel group design using an allocation ratio of 1:1. METHODS: Eighty patients underwent elective tonsillectomy or adenotonsillectomy, operated on by one surgeon. They were discharged home with randomly assigned celecoxib or placebo, together with regular post-tonsillectomy medications (paracetamol and Endone)...
January 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28160140/optimizing-outpatient-pain-management-after-thyroid-and-parathyroid-surgery-a-two-institution-experience
#15
Irene Lou, Todd B Chennell, Sarah C Schaefer, Herbert Chen, Rebecca S Sippel, Courtney Balentine, David F Schneider, Jacob Moalem
BACKGROUND: Thyroidectomy and parathyroidectomy are the most commonly performed endocrine operations, and are increasingly being completed on a same-day basis; however, few data exist regarding the outpatient postoperative pain requirement of these patients. We aimed to describe the outpatient narcotic medication needs for patients undergoing thyroid and parathyroid surgery, and to identify predictors of higher requirement. METHOD: We examined patients undergoing thyroid and parathyroid surgery at two large academic institutions from 1 January-30 May 2014...
February 3, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28153763/multiply-repeatable-and-adjustable-on-demand-phototriggered-local-anesthesia
#16
Alina Y Rwei, Changyou Zhan, Bruce Wang, Daniel S Kohane
A phototriggerable system whereby patients could repeatedly and non-invasively control the timing and dosage of local anesthesia according to their needs would be beneficial for perioperative pain and perhaps obviate the need for oral narcotics. However, clinical application of phototriggerable systems have been limited by concerns over phototoxicity of lasers and limited tissue penetration of light. To address these limitations, we increased the devices' effective sensitivity to light by co-delivering a second compound, dexmedetomidine, that potentiates the effect of delivered local anesthetics...
January 31, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28149550/management-of-acute-postoperative-pain-with-continuous-intercostal-nerve-block-after-single-port-video-assisted-thoracoscopic-anatomic-resection
#17
Ming-Ju Hsieh, Kuo-Cheng Wang, Hung-Pin Liu, Diego Gonzalez-Rivas, Ching-Yang Wu, Yun-Hen Liu, Yi-Cheng Wu, Yin-Kai Chao, Ching-Feng Wu
BACKGROUND: Effective postoperative pain control for thoracic surgery is very important, not only because it reduces pulmonary complications but also because it accelerates the pace of recovery. Moreover, it increases patients' satisfaction with the surgery. In this study, we present a simple approach involving the safe placement of intercostal catheter (ICC) after single port video-assisted thoracoscopic surgery (VATS) anatomic resection and we evaluate postoperative analgesic function with and without it...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28148486/early-death-after-discharge-from-emergency-departments-analysis-of-national-us-insurance-claims-data
#18
Ziad Obermeyer, Brent Cohn, Michael Wilson, Anupam B Jena, David M Cutler
OBJECTIVE:  To measure incidence of early death after discharge from emergency departments, and explore potential sources of variation in risk by measurable aspects of hospitals and patients. DESIGN:  Retrospective cohort study. SETTING:  Claims data from the US Medicare program, covering visits to an emergency department, 2007-12. PARTICIPANTS:  Nationally representative 20% sample of Medicare fee for service beneficiaries...
February 1, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28143718/comparative-efficacy-of-bilateral-thoracoscopic-splanchnicectomy-for-intractable-pain-secondary-to-pancreatic-cancer-vs-chronic-pancreatitis
#19
Neal Bhutiani, Gerald A Cheadle, Michael H Bahr, Gary C Vitale
BACKGROUND: Splanchnicectomy has been evaluated for treatment of chronic pain in both pancreatic cancer and chronic pancreatitis patients, though its efficacy has not been compared in these two patient populations. This study aims to compare bilateral thoracoscopic splanchnicectomy (BTS) in treatment of abdominal pain secondary to pancreatic cancer (PC) and chronic pancreatitis (CP). METHODS: A University of Louisville database was evaluated from July 1998 to March 2016 for patients undergoing BTS for intractable pain secondary to PC (n=48) or CP (n=75)...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28139321/healthcare-usage-after-uvulopalatopharyngoplasty-impact-of-analgesic-regimen
#20
William S Tierney, Gabriel Gabarain, Alan H Kominsky
OUTCOME OBJECTIVES: 1) Analyze differences in healthcare usage between subjects receiving different perioperative analgesic medications after uvulopalatopharyngoplasty (UPPP) surgery. 2) Comment on the impact of perioperative analgesic medication on length of hospital stay and complications after UPPP. METHODS: A retrospective cohort study of 120 UPPPs conducted by a single surgeon in the past 5years was conducted. Subjects were grouped based on perioperative pain medication regimen into three groups; narcotics alone (n=83), narcotics with gabapentin (n=27), or narcotics with ketorolac tromethamine (n=10)...
January 23, 2017: American Journal of Otolaryngology
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