International journal of clinical practice
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Int. J. Clin. Pract. · Jan 2020
Associations between serum potassium and adverse clinical outcomes: A systematic literature review.
Despite the growing body of evidence characterising the association between serum potassium levels and adverse clinical outcomes, a contemporary summary of available evidence is currently lacking. The objective of this study, therefore, was to undertake a systematic literature review to identify all relevant evidence assessing risk factors associated with the incidence of hyperkalaemia (HK) and also quantifying the effect of serum potassium levels on risk of adverse clinical outcomes. ⋯ The current body of published evidence is compelling in its confirmation of the associations between serum potassium levels and adverse clinical outcomes. This review further highlights the importance of avoiding both hyper- and hypokalaemia, in order to reduce risk of mortality, hospitalisation, MACE and RAASi discontinuation or down-titration.
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Therapeutic drug switching is commonplace across a broad range of indications and, within a drug class, is often facilitated by the availability of multiple drugs considered equivalent. Such treatment changes are often considered to improve outcomes via better efficacy or fewer side effects, or to be more cost-effective. Drug switching can be both appropriate and beneficial for several reasons; however, switching can also be associated with negative consequences. ⋯ Lessons emerging from these examples will help inform healthcare practitioners who may be considering switching drug prescriptions.
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Int. J. Clin. Pract. · Jan 2020
Randomized Controlled Trial Comparative StudyComparison of tramadol versus tramadol with paracetamol for efficacy of postoperative pain management in lumbar discectomy: A randomised controlled study.
Despite developments in the treatment of pain, the availability of new drugs or increased knowledge of pain management, postoperative pain control after different surgeries remains inadequate. We aimed to compare the postoperative analgesic efficacy of tramadol versus tramadol with paracetamol after lumbar discectomy. ⋯ The administration of tramadol with paracetamol was more effective than tramadol alone for early acute postoperative pain therapy following lumbar discectomy. Therefore, while adding paracetamol in early pain management is recommended, continuing paracetamol for the late postoperative period is not advised.
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Int. J. Clin. Pract. · Jan 2020
National trends of acute pericarditis post-atrial fibrillation ablation.
Atrial fibrillation ablation increased over the last two decades by its high success rate. However, the trend of inpatient adverse outcomes is limited. The aim of this study to examine the frequency and predictors of acute pericarditis resulting from catheter ablation. ⋯ Post-AF ablation, in-hospital acute pericarditis showed inconsistent fluctuation leaning towards reduction. Female gender and obesity are at higher risk for developing acute pericarditis post-AF ablations. Proper evaluation might alter those complications.
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Although healthy volunteers often serve as controls or primary participants in neuroscience research, they are usually less rigorously screened than patients, which can have far-reaching implications for interpretation of study results. Although this issue has long been recognised, it is rarely discussed in the research literature. This article examines how the rigorous screening and characterisation of healthy volunteers is key for quality research.