J Formos Med Assoc
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Prescribing of opioids to patients with non-cancer pain is strictly regulated in Taiwan, but tramadol is not included in the regulation on chronic opioid prescribing. This study aims to identify the utilization trend of prescribing tramadol and other opioid analgesics and investigate the influence of government regulation on opioid prescribing in Taiwan. ⋯ The regulation in Taiwan limited the prescribing of selective opioids for patients with non-cancer pain and the substitution of tramadol for other opioids may have safety implications.
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Hepatic disease accounts for approximately 2 million deaths/year worldwide. Liver fibrosis, as the last stage of numerous chronic liver diseases, is one of the most relevant prognostic factors. The liver biopsy with the histopathological examination is considered to be the "gold standard" for the identification and staging of the hepatic fibrosis. ⋯ Research studies conducted in the last few years focused on identifying non-invasive type methods for the evaluation of hepatic fibrosis; usually, there are 2 categories of such investigations: serologic tests and imaging techniques. This narrative review presents the non-invasive investigation methods used in the liver fibrosis evaluation. New molecular perspectives on fibrogenesis and fibrosis regression, as well as the appearance of therapeutic antifibrotic agents, justify the necessity of non-invasive tools to detect and grade liver fibrosis.
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Randomized Controlled Trial
Tuning consciousness: Anesthetic-sparing effect of varying sound on sedative anesthesia.
This study aimed to identify the anesthetic-sparing effect of different intraoperative sound on sedated patients under propofol target controlled infusion anesthesia (TCI). 90 patients scheduled for transvaginal oocyte retrieval surgery (TVOR) were available and randomized into three groups: patients isolated from background noise(S), patients listened to a voice calling their names (CN), or patients listened to the classical music (CM). The main outcome was the value of total propofol consumption/surgical time. ⋯ The value of ΔEntropy and ΔCE for the CM group were also lower than that for the CN group (-2.17 ± 4.13 vs. 1.33 ± 3.43, P-value<0.001) (-0.17 ± 0.28 vs. 0.07 ± 0.25, P-value<0.001). We concluded that participants under propofol TCI who were listening to classical music had lower CE value, Entropy level and reduced 22.48% total propofol consumption/surgical time compared to those called by their names.