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https://www.readbyqxmd.com/read/28430785/medical-expulsive-therapy-for-ureter-stone-using-naftopidil-a-multicenter-randomized-double-blind-and-placebo-controlled-trial
#1
Sung Yong Cho, Woong Na, Sang Wook Lee, Min Chul Cho, Jong Jin Oh, Sangchul Lee, Juhyun Park, Soyeon Ahn, Chang Wook Jeong
OBJECTIVES: A prospective, multicenter, randomized, double-blind, placebo-controlled trial evaluated the effects of naftopidil 75 mg for medical expulsive therapy for a single ureter stone. MATERIALS AND METHODS: Patients diagnosed with a ureter stone were prescribed aceclofenac 100 mg or a combined medication of tramadol 37.5 mg and acetaminophen 325 mg. Patients then randomly received either naftopidil 75 mg or placebo. Primary endpoint was the stone passage rate at 14 days after medication...
2017: PloS One
https://www.readbyqxmd.com/read/28430165/treatments-for-latrodectism-a-systematic-review-on-their-clinical-effectiveness
#2
REVIEW
Nicole M Ryan, Nicholas A Buckley, Andis Graudins
Latrodectism or envenomation by widow-spiders is common and clinically significant worldwide. Alpha-latrotoxin is the mammalian-specific toxin in the venom that results in toxic effects observed in humans. Symptoms may be incapacitating and include severe pain that can persist for days. The management of mild to moderate latrodectism is primarily supportive while severe cases have variously been treated with intravenous calcium, muscle relaxants, widow-spider antivenom and analgesic opioids. The object of this systematic review is to examine the literature on the clinical effectiveness of past and current treatments for latrodectism...
April 21, 2017: Toxins
https://www.readbyqxmd.com/read/28428507/-opioid-therapy-and-management-of-side-effects-associated-with-opioids
#3
Toshihiko Nakatani
Opioids are very useful medications to reduce suffering of cancer patients such as refractory pain and dyspnea. We physicians have to use opioids to have good management of pain and suffering associated with cancer including management of side effects caused by opioids. Opioids couple opioid receptors and affect several pharmacological effects. Other than analgesic effect, opioids have some side effects of constipation, nausea and vomiting, respiratory depression. In this chapter, I take important side effects of constipation, nausea and vomiting and respiratory depression...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28425307/epidural-fentanyl-does-not-affect-cervical-dilation-and-progress-of-first-stage-of-vaginal-delivery-a-randomized-double-blind-study
#4
Chryssoula Staikou, Theodoros Kalampokas, Emmanouil Kalampokas, Sophia Vassiloglou, Anteia Paraskeva
OBJECTIVE: Local anesthetics combined with opioids are commonly used in labor epidural analgesic schemes. We investigated if the addition of fentanyl to epidural ropivacaine can affect cervical dilation and progress of vaginal delivery. METHODS: Sixty-two nulliparous parturients were randomized to receive epidurally 8ml ropivacaine 0.2% combined with fentanyl 20μg (F/R-group, n = 31) or with normal saline 0.4ml (R-group, n = 31), every hour. Rescue doses of 5ml ropivacaine 0...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28422818/inhibition-of-metabotropic-glutamate-receptor-subtype-1-alters-the-excitability-of-the-commissural-pyramidal-neuron-in-the-rat-anterior-cingulate-cortex-after-chronic-constriction-injury-to-the-sciatic-nerve
#5
Shi-Hao Gao, Lin-Lin Shen, Hui-Zhong Wen, Yan-Dong Zhao, Huai-Zhen Ruan
BACKGROUND: Inhibition of the metabotropic glutamate receptor subtype 1 in the anterior cingulate cortex has an analgesic effect during sustained nociceptive hypersensitivity. However, the specific changes in different subtypes of anterior cingulate cortex layer 5 pyramidal neurons, as well as the distinct effect of metabotropic glutamate receptor subtype 1 inhibition on different neuronal subtypes, have not been well studied. METHODS: Retrograde labeling combined with immunofluorescence, whole cell clamp recording, and behavioral tests combined with RNA interference were performed in a rat model of chronic constriction injury to the sciatic nerve...
April 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28415931/comparison-of-dexmedetomidine-and-propofol-for-conscious-sedation-in-inguinal-hernia-repair-a-prospective-randomized-controlled-trial
#6
Hong-Mei Wang, Xiao-Yu Shi, Xia-Rong Qin, Jia-Li Zhou, Yan-Fei Xia
Objective The ideal agents for conscious sedation during ambulatory inguinal hernia repair are still unclear. We aimed to compare the analgesic, sedative, haemodynamic, and side effects of dexmedetomidine with those of propofol in combination with fentanyl for conscious sedation in patients undergoing inguinal hernia repair. Methods Eighty patients undergoing unilateral inguinal hernia repair were prospectively randomized to receive either dexmedetomidine (n = 40) or propofol (n = 40). Dexmedetomidine and propofol dosages were adjusted to maintain the targeted level of sedation...
April 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28413629/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-1-from-the-preoperative-period-to-pacu
#7
Matthew D McEvoy, Michael J Scott, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia," which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multi-disciplinary, international group of clinicians, and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413628/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#8
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413281/a-comparative-study-of-the-effect-of-clonidine-fentanyl-and-the-combination-of-both-as-adjuvant-to-intrathecal-bupivacaine-for-postoperative-analgesia-in-total-abdominal-hysterectomy
#9
Fareed Ahmed, Mamta Khandelwal, Anil Sharma
BACKGROUND AND AIMS: The aim of this study was to evaluate the level of sensory block, onset and duration of motor block, postoperative analgesia, and adverse effects of combination of clonidine and fentanyl given intrathecally with hyperbaric bupivacaine (HB). MATERIAL AND METHODS: Three hundred and twenty eight patients were randomized into four groups. Group bupivacaine (group B) received 15 mg of HB; group bupivacaine clonidine (group BC) received 15 mg of HB plus 25 μg clonidine; group bupivacaine fentanyl (group BF) received 15 mg of HB plus 25 μg fentanyl and group bupivacaine clonidine fentanyl (group BCF) received 15 mg of HB plus 25 μg clonidine and 25 μg fentanyl intrathecally...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28410338/multiple-sources-of-prescription-payment-and-risky-opioid-therapy-among-veterans
#10
William C Becker, Brenda T Fenton, Cynthia A Brandt, Erin L Doyle, Joseph Francis, Joseph L Goulet, Brent A Moore, Virginia Torrise, Robert D Kerns, Peter W Kreiner
BACKGROUND: Opioid overdose and other related harms are a major source of morbidity and mortality among US Veterans, in part due to high-risk opioid prescribing. OBJECTIVES: We sought to determine whether having multiple sources of payment for opioids-as a marker for out-of-system access-is associated with risky opioid therapy among veterans. RESEARCH DESIGN: Cross-sectional study examining the association between multiple sources of payment and risky opioid therapy among all individuals with Veterans Health Administration (VHA) payment for opioid analgesic prescriptions in Kentucky during fiscal year 2014-2015...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28403084/the-comparative-preemptive-analgesic-efficacy-of-addition-of-vitamin-b-complex-to-gabapentin-versus-gabapentin-alone-in-women-undergoing-cesarean-section-under-spinal-anesthesia-a-prospective-randomized-double-blind-study
#11
Marzieh Beigom Khezri, Nahid Nasseh, Ghodratollah Soltanian
BACKGROUND: Development of new multimodal analgesic regimens have led to substantial improvement in postoperative pain relief. We designed this study to compare the effect of combined vitamin B complex-gabapentin versus gabapentin alone on postoperative pain in women undergoing cesarean section under spinal anesthesia. METHODS: One hundred twenty-eight women who underwent cesarean section under spinal anesthesia were randomized to receive orally 300 mg gabapentin (group G) or 300 mg of gabapentin plus 2 vitamin B complex (group GB) tablets 30 minutes before surgery...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28393429/lack-of-analgesic-synergy-of-the-cholecystokinin-receptor-antagonist-proglumide-and-spinal-cord-stimulation-for-the-treatment-of-neuropathic-pain-in-rats
#12
Shinsuke Inoue, Lisa M Johanek, Kathleen A Sluka
OBJECTIVE: Neuropathic pain is difficult to manage and treat. Spinal cord stimulation (SCS) has become an established procedure for treating chronic neuropathic pain that is refractory to pharmacological therapy. In order to achieve better analgesia, a number of studies have evaluated the effectiveness of combining drug therapy with SCS. Cholecystokinin antagonists, such as proglumide, enhance the analgesic efficacy of endogenous opioids in animal models of pain. We previously reported that both systemic and spinal administration of proglumide enhances analgesia produced by both low- and high-frequency transcutaneous electrical nerve stimulation (TENS)...
April 10, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28391258/dexmedetomidine-combined-with-therapeutic-hypothermia-is-associated-with-cardiovascular-instability-and-neurotoxicity-in-a-piglet-model-of-perinatal-asphyxia
#13
Mojgan Ezzati, Go Kawano, Eridan Rocha-Ferreira, Daniel Alonso-Alconada, Jane K Hassell, Kevin D Broad, Igor Fierens, Bobbi Fleiss, Alan Bainbridge, David L Price, Pardis Kaynezhad, Brian Anderson, Mariya Hristova, Ilias Tachtsidis, Xavier Golay, Pierre Gressens, Robert D Sanders, Nicola J Robertson
The selective α2-adrenoreceptor agonist dexmedetomidine has shown neuroprotective, analgesic, anti-inflammatory, and sympatholytic properties that may be beneficial in neonatal encephalopathy (NE). As therapeutic hypothermia is only partially effective, adjunct therapies are needed to optimize outcomes. The aim was to assess whether hypothermia + dexmedetomidine treatment augments neuroprotection compared to routine treatment (hypothermia + fentanyl sedation) in a piglet model of NE using magnetic resonance spectroscopy (MRS) biomarkers, which predict outcomes in babies with NE, and immunohistochemistry...
April 8, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28385937/multimodal-infiltration-of-local-anaesthetic-in-total-knee-arthroplasty-is-posterior-capsular-infiltration-worth-the-risk-a-prospective-double-blind-randomised-controlled-trial
#14
P Pinsornsak, S Nangnual, K Boontanapibul
AIMS: Multimodal infiltration of local anaesthetic provides effective control of pain in patients undergoing total knee arthroplasty (TKA). There is little information about the added benefits of posterior capsular infiltration (PCI) using different combinations of local anaesthetic agents. Our aim was to investigate the effectiveness of the control of pain using multimodal infiltration with and without infiltration of the posterior capsule of the knee. PATIENTS AND METHODS: In a double-blind, randomised controlled trial of patients scheduled for unilateral primary TKA, 86 were assigned to be treated with multimodal infiltration with (Group I) or without (Group II) PCI...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28384011/tadalafil-facilitates-the-distal-ureteral-stone-expulsion-a-meta-analysis
#15
Yunjin Bai, Yubo Yang, Xiaoming Wang, Yin Tang, Ping Han, Jia Wang
OBJECTIVE: To assess the efficacy and safety of tadalafil in facilitating the spontaneous passage of distal ureteral stones. METHODS: The relevant studies were identified by searching MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to November 2016. Randomized controlled trials evaluating effects of tadalafil for distal ureteral stones were included. RESULTS: Six publications involving 921 patients were included...
April 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28383293/peripheral-nerve-block-as-a-supplement-to-light-or-deep-general-anesthesia-in-elderly-patients-receiving-total-hip-arthroplasty-a-prospective-randomized-study
#16
Bin Mei, Hanning Zha, Xiaolong Lu, Xinqi Cheng, Shishou Cheng, Xuesheng Liu, Yuanhai Li, Erwei Gu
BACKGROUND: Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we aimed to investigate the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. METHODS: Patients aged 65 years and older undergoing total hip arthroplasty were randomized into three groups: a general anesthesia without lumbosacral plexus block group, and two general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep)...
April 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28382293/combined-spinal-epidural-anesthesia-in-laparoscopic-appendectomy-a-prospective-feasibility-study
#17
Sinan Uzman, Turgut Donmez, Vuslat Muslu Erdem, Adnan Hut, Dogan Yildirim, Muzaffer Akinci
PURPOSE: Laparoscopic appendectomy (LA) is routinely performed under general, not regional anesthesia. This study assessed the feasibility, efficacy, and side effects of combined spinal-epidural anesthesia (CSEA) in LA. METHODS: Thirty-three American Society of Anesthesiologist (ASA) physical status classification grade I patients underwent LA under CSEA. CSEA was performed using the needle-through-needle technique at the L3-L4 interspace. Preoperative and postoperative adverse events related to CSEA, patient satisfaction, and postoperative pain levels were recorded...
April 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28377055/original-endomorphin-1-analogues-exhibit-good-analgesic-effects-with-minimal-implications-for-human-sperm-motility
#18
Yiqing Wang, Xinyi Zhao, Xuelin Gao, Yongan Gan, Ying Liu, Xiaodong Zhao, Junping Hu, Xiaoling Ma, Yanjing Wu, Pengcheng Ma, Xiaolei Liang, Xuehong Zhang
To search a novel analgesic characterizes the effects on human sperm motility as minimal as possible. A new class of endomorphin-1 (EM-1) analogues was synthesized by combining successful chemical modifications including N-terminal guanidino modification, Phe(4) was chlorinated, replaced of l-Pro(2)-Trp(3) by d-Ala(2)-Gly(3) or d-Pro(2)-Gly(3) at position 2 and 3. Their bioactivities were measured by radioligand binding assay, metabolic stability, antinociception activity and sperm motility effects. In radioligand binding assays, analogue GAGP shown a μ-opioid receptor affinity about 17...
March 27, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28375916/neuropathic-pain
#19
Lindsay A Zilliox
PURPOSE OF REVIEW: Neuropathic pain is a frequently encountered condition that is often resistant to treatment and is associated with poor patient satisfaction of their treatment. Several medications have been shown to be effective in treating neuropathic pain associated with diabetic neuropathy and postherpetic neuralgia, and these medications are often used to treat neuropathic pain associated with other conditions as well. This article summarizes the diagnosis and assessment of patients with neuropathic pain as well as available pharmacologic and interventional treatment options...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28375116/synthesis-physicochemical-characterization-and-pharmacological-investigation-of-indolacin-5-fluorouracil-1-ylmethyl-ester
#20
Jing Wang, Mei-Juan Zou, Lei Chen, Yi-Ling Sheng, Xiao-Mian Zhou, Xiang-Rong Zhang
The objective of this work is to synthesize indolacin-5-fluorouracil-1-ylmethyl ester and the structure was confirmed by means of UV, IR, (1)H-NMR, (13)C-NMR and mass spectrometry. The physicochemical parameters of melting point, solubility, apparent partition coefficient were investigated. S180 sarcoma, H22 hapatitic cancer and Lewis-transplanted mice were used to evaluate the anti-tumor activity of indolacini-5-fluorouracil-1-ylmethyl ester compared with 5-fluorouracil in vivo. Anti-inflammatory and analgesic activities were evaluated in mice...
November 2016: Pakistan Journal of Pharmaceutical Sciences
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