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David F Woodward, Jenny W Wang, Ming Ni, Alex Bauer, Jose L Martos, Robert W Carling, Neil J Poloso
The purpose of these studies was to test the hypothesis that a selected polypharmacological approach for treating the prostanoid-mediated component of inflammatory diseases would produce a therapeutic effect superior to global inhibition of prostaglandin (PG) biosynthesis by aspirin-like drugs. The compound studied was AGN 211377, which had been previously shown to produce a superior effect on cytokine release from human macrophages compared with cyclooxygenase (COX) inhibitors. AGN 211377 antagonizes prostanoid prostaglandin D2 (DP)1, DP2, prostaglandin E2 (EP)1, EP4, prostaglandin F2α, and thromboxane A2 receptors but not anti-inflammatory EP2, prostaglandin I2, or EP3 receptors...
October 21, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
J Quiralte-Castillo, M Del Robledo Ávila-Castellano, S Cimbollek, P Benaixa, S Leguisamo, K Baynova, M Labella, J Quiralte
BACKGROUND: Safer and less time consuming alternatives to single-blind placebo-controlled oral challenge (SBPCOC) in order to diagnose aspirin-exacerbated respiratory disease (AERD) have been searched for. Nasal challenges with different non-steroidal anti-inflammatory drugs and assessment methods have been developed. OBJECTIVE: Our objective was to evaluate the utility and safety of nasal ketorolac challenge (NKC) using an acoustic rhinomether in patients with suspected AERD Methods: Thirty-six patients with suspected AERD were included in the study...
October 19, 2016: Journal of Investigational Allergology & Clinical Immunology
Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
October 3, 2016: Anesthesia and Analgesia
Dafna Willner, Valeria Spennati, Shelly Stohl, Giulia Tosti, Simone Aloisio, Federico Bilotta
Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraoperative and postoperative blood loss. The aim of this systematic review is to report clinical evidence on the relationship between intraoperative blood loss (primary outcome) and on transfusion requirements and postoperative complications (secondary outcomes) in patients undergoing spine surgery...
October 3, 2016: Anesthesia and Analgesia
Venkatesh Selvaraj
BACKGROUND: Clonidine is an effective adjuvant to local anesthetics in peripheral nerve blocks. We studied the effect of clonidine as an adjuvant in wound infiltration for postoperative analgesia. AIM: To evaluate the role of clonidine as an adjuvant to bupivacaine in wound infiltration in terms of quality and duration of postoperative analgesia in patients undergoing total abdominal hysterectomy. SETTINGS AND STUDY DESIGN: Prospective, randomized, double-blinded study...
September 2016: Anesthesia, Essays and Researches
Nitesh Patel, Ayesha Bryant, Kensi Duncan, Promil Kukreja, Mark F Powell
PURPOSE: Intrathecal morphine provides superior pain control for patients undergoing cesarean delivery when compared to intravenous opioid patient-controlled analgesia. However, no study has assessed the overall cost associated with each modality as a primary outcome. The aim of this study is to determine the overall cost of each modality for the first 24 h post cesarean delivery. METHODS: Charts of patients undergoing cesarean delivery at our institution from January 1, 2014 to December 31, 2014 were reviewed...
October 14, 2016: Journal of Anesthesia
Michael Burdick, Richard Mamelok, Michele Hurliman, Mariève Dupuis, Yuli Xie, Julie Grenier, Curtis Sheldon, Michael Gartner, Peter Noymer
Ketorolac tromethamine is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits analgesic activity with no sedative or anxiolytic properties. Twelve (12) healthy male subjects were enrolled in a study to receive either one of two treatments over two periods in an open-label, randomized, two-way crossover design: (A) 120 mg of ketorolac tromethamine administered as a continuous subcutaneous (SC) infusion over a 24-hour period; or (B) an identical total daily dose administered as 4 intramuscular (IM) bolus injections of 30 mg each given every 6 hours (current labeled treatment regimen)...
October 14, 2016: Clinical Pharmacology in Drug Development
Eric C McCarty, Matthew J Kraeutler, Paula Langner, Shane Cook, Byron Ellis, Jenna M Godfrey
We conducted a study to identify and contrast patterns in the treatment of common injuries that occur in National Football League (NFL) players and National Collegiate Athletic Association (NCAA) Division I football players. Orthopedic team physicians for all 32 NFL and 119 NCAA Division I football teams were asked to complete a survey regarding demographics and preferred treatment of a variety of injuries encountered in football players. Responses were received from 31 (97%) of the 32 NFL and 111 (93%) of the 119 NCAA team physicians...
September 2016: American Journal of Orthopedics
Naoto Fujii, Sheila M Dervis, Ronald J Sigal, Glen P Kenny
Both cyclooxygenase (COX) and nitric oxide synthase (NOS) contribute to sweating, whereas NOS alone contributes to cutaneous vasodilation during exercise in the heat. Here, we evaluated if type 1 diabetes mellitus (T1DM) modulates these responses. Adults with (n=11, 25±5 years) and without (n=12, 24±4 years) T1DM performed two bouts of 30-min cycling at a fixed rate of heat production of 400W in the heat (35°C); each followed by a 20- and 40-min recovery period respectively. Sweat rate and cutaneous vascular conductance (CVC) were measured at four intradermal microdialysis sites treated with either 1) lactated Ringer (vehicle control site), 2) 10mM ketorolac (non-selective COX inhibitor), 3) 10mM N(G)-nitro-L-arginine methyl ester (non-selective NOS inhibitor), or 4) a combination of both inhibitors...
October 12, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
J S Berger, A Gonzalez, A Hopkins, T Alshaeri, D Jeon, S Wang, R L Amdur, R Smiley
BACKGROUND: The appropriate dose of intrathecal morphine for post-cesarean analgesia is unclear. With the inclusion of routine non-steroidal anti-inflammatory drugs, the required dose of morphine may be significantly less than the 200-300μg common a decade ago. We performed a two-center, prospective, randomized, blinded trial comparing three doses of intrathecal morphine, combined with routine intravenous ketorolac, in 144 healthy women undergoing elective cesarean delivery. METHODS: Patients received an intrathecal injection of hyperbaric bupivacaine 12mg, fentanyl 15μg and a randomized dose of 50, 100, or 150μg morphine in a volume of 2...
August 28, 2016: International Journal of Obstetric Anesthesia
Roberto Gonzalez-Salinas, Adriano Guarnieri, María Concepción Guirao Navarro, Manuel Saenz-de-Viteri
Cataract, a degradation of the optical quality of the crystalline lens, progressive and age-related, is the leading cause of treatable blindness worldwide. Cataract surgery is the most common surgical procedure performed by ophthalmologists and is the only effective treatment for cataracts. Advances in the surgical techniques and better postoperative visual outcomes have progressively changed the primary concern of cataract surgery to become a procedure refined to yield the best possible refractive results...
2016: Patient Preference and Adherence
Angela M Sousa, Giovanna M C Rosado, Jose de S Neto, Gabriel M N Guimarães, Hazem A Ashmawi
STUDY OBJECTIVE: The aim of this study is to compare the analgesic effect of intravenous infusion of magnesium sulfate to ketorolac during laparoscopic surgeries. DESIGN: Double-blind randomized controlled trial. SETTING: University-affiliated teaching hospital. PATIENTS: Sixty women submitted to laparoscopic gynecologic oncology surgeries. INTERVENTIONS: Intravenous ketorolac 30 mg in bolus followed by saline infusion (group K), intravenous magnesium sulfate 20 mg/kg in bolus followed by magnesium 2 mg kg(-1) h(-1) (group M) or intravenous saline solution 20 mL in bolus followed by saline infusion during the entire procedure (group S)...
November 2016: Journal of Clinical Anesthesia
Zhen Ding, Kaiguo Wang, Baosheng Wang, Naibao Zhou, Hao Li, Bo Yan
BACKGROUND: It has been suggested that oxycodone is effective in relieving acute postoperative pain. The aim of this study was to investigate the efficacy and tolerability of oxycodone (O) versus fentanyl (F), and the adequate potency ratio of oxycodone and fentanyl in patients with intravenous patient-controlled analgesia after gastric laparotomy. METHODS: In this double-blinded, randomized, controlled study, 60 patients undergoing elective gastric laparotomy were allocated to receive either oxycodone or fentanyl for postoperative intravenous patient-controlled analgesia (potency ratio 60:1)...
September 2016: Medicine (Baltimore)
Andrea Arfè, Lorenza Scotti, Cristina Varas-Lorenzo, Federica Nicotra, Antonella Zambon, Bianca Kollhorst, Tania Schink, Edeltraut Garbe, Ron Herings, Huub Straatman, René Schade, Marco Villa, Silvia Lucchi, Vera Valkhoff, Silvana Romio, Frantz Thiessard, Martijn Schuemie, Antoine Pariente, Miriam Sturkenboom, Giovanni Corrao
OBJECTIVES:  To investigate the cardiovascular safety of non-steroidal anti-inflammatory drugs (NSAIDs) and estimate the risk of hospital admission for heart failure with use of individual NSAIDs. DESIGN:  Nested case-control study. SETTING:  Five population based healthcare databases from four European countries (the Netherlands, Italy, Germany, and the United Kingdom). PARTICIPANTS:  Adult individuals (age ≥18 years) who started NSAID treatment in 2000-10...
September 28, 2016: BMJ: British Medical Journal
S Vilasagar, M Towner, K Congelosi, S J Caveglia, D Kumar, B Bhagavath
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Jeffrey S Kroin, Jinyuan Li, Mario Moric, Brian W Birmingham, Kenneth J Tuman, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: There is an increasing use of local infiltration analgesia (LIA) to reduce postoperative pain. Despite widespread use of LIA, wide variations in drug combinations and concomitant use of systemic analgesics have made it difficult to determine the optimal drug combinations for LIA. Using a previously validated rat laparotomy model, the optimal LIA combination of medications to reduce postoperative pain was determined. METHODS: Laparotomy was performed in an adult rat model under isoflurane anesthesia...
September 22, 2016: Regional Anesthesia and Pain Medicine
Harprit Kaur Madan, Rajinder Singh, Gurdip Singh Sodhi
INTRODUCTION: Propofol possesses many characteristics of an ideal intravenous anaesthetic agent, providing a smooth induction and a rapid recovery. However, it has been reported to evoke considerable pain on injection in 10-100% of patients. The cause of pain upon intravenous injection of propofol remains a mystery. AIM: To study and compare the efficacy of Lignocaine, Tramadol and Ketorolac in minimizing the propofol injection pain. MATERIALS AND METHODS: Hundred adult patients (ASA grade I and grade II) scheduled for elective surgery under general anaesthesia with propofol as an inducing agent were considered for the study...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Emily N Schneider, Regan Riley, Eve Espey, Shiraz I Mishra, Rameet H Singh
OBJECTIVES: To evaluate whether inhaled nitrous oxide with oxygen (N2O/O2) is associated with less pain compared to oral sedation for pain management during in-office hysteroscopic sterilization. STUDY DESIGN: This double blinded randomized controlled trial enrolled women undergoing in-office hysteroscopic sterilization. All participants received pre-procedure intramuscular ketorolac and a standardized paracervical block. The intervention group also received N2O/O2 via a nasal mask titrated to a maximum 70%:30% mixture by a nurse during the procedure and placebo pills pre-procedure and the active control group received inhaled O2 during the procedure and 5/325 mg hydrocodone/acetaminophen and 1 mg lorazepam pre-procedure...
September 9, 2016: Contraception
Piyush Jha, Choon-Mee Kim, Dong-Min Kim, Jong-Hoon Chung, Na-Ra Yoon, Babita Jha, Seok Won Kim, Sook Jin Jang, Young-Joon Ahn, Jae Keun Chung, Doo Young Jeon
Enterobacter aerogenes is recognized as an important bacterial pathogen in hospital-acquired infections. This report describes two unusual cases of septicemia caused by E. aerogenes in immunocompetent healthcare workers. E. aerogenes was isolated from blood cultures of the two patients experiencing septicemia. The clinical isolates were initially identified as E. aerogenes using a VITEK II automated system and 16S rRNA sequence analysis, and; both isolates involved in the outbreak shared a common pulse-field gel electrophoresis pattern...
2016: SpringerPlus
Rebecca E Rosenberg, Stacey Trzcinski, Mindy Cohen, Mark Erickson, Thomas Errico, Lisa McLeod
STUDY DESIGN: Comparative effectiveness database study. OBJECTIVE: To describe variation in use of adjuvant therapies for managing postoperative pain in in patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic (AIS) and determine association between use of these therapies and patient outcomes. SUMMARY OF BACKGROUND DATA: Variation in postoperative pain management for children undergoing PSF for AIS likely impacts outcomes...
August 31, 2016: Spine
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