Irish journal of medical science
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Patient knowledge of perioperative care, particularly the role of the anaesthetist, appears limited. ⋯ Patients' knowledge of perioperative care is limited, with very little change during hospital stay. Novel educational approaches may be required to increase basic medical knowledge.
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Concern about delay in the treatment of serious head injury may result in unnecessary transfer to neurosurgical units for scanning and neurosurgical assessment. ⋯ A CT scan and image-link facility permitting remote neurosurgical advice allows the majority of patients with head injury to be safely managed in well-equipped regional units without onsite neurosurgical expertise.
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Most patients with acute stroke are admitted to hospital. If stroke services in this country are to be improved, we need accurate and reliable information about the types of stroke patients being admitted, their present management and outcome. ⋯ The results demonstrate the high mortality and prolonged hospital stay for stroke patients in this area and emphasise the need for co-ordinated stroke care and regular audit to ensure most effective use of hospital resources.
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Comparative Study
A comparison of papaveretum-promethazine with morphine-ondansetron for patient-controlled analgesia.
Patient-controlled analgesia (PCA) with intravenous morphine is commonplace. Antiemetics are often added to reduce side-effects. In our institution an unusual combination of papaveretum-promethazine is in use. ⋯ Papaveretum-promethazine appeared to be effective for PCA. This combination is also much less expensive than morphine-ondansetron. A previously described synergistic interaction between promethazine and opiates may be a factor in its success. Further evaluation of these drugs in PCA is warranted.
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Review Comparative Study
Non-steroidal anti-inflammatory drugs (NSAIDs) and gastro-intestinal toxicity: current issues.
Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs and their widespread use is associated with increased gastro-intestinal toxic effects such as ulceration, haemorrhage, perforation and death. They result in these complications mainly by reducing cytoprotective prostaglandins (PGE2 and PGI2) in the stomach, through the inhibition of cyclo-oxygenase (COX) enzyme. The increased morbidity and mortality, in addition to enormous cost, associated with NSAID-associated side effects, necessitates a need for safer GI-friendly NSAID. ⋯ These agents preserve the COX-1 that is responsible for the production of cytoprotective prostaglandins in the stomach and selectively inhibit COX-2 induced at the sites of inflammation. Selective COX-2 inhibitors exert the same analgesic and anti-inflammatory effects as the existing NSAIDs but may be less toxic to the stomach. In this review the background development and well-structured clinical trials on this new generation NSAIDs are discussed.