International journal of clinical and experimental medicine
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The aim of this study was to identify predictive factors for higher conversion ratio in opioid switching from oral oxycodone to transdermal fentanyl (TDF) in patients with cancer pain. The participants of this study were 156 hospitalized cancer patients who underwent opioid switching from oral oxycodone to TDF at the Affiliated Hospital of Binzhou Medical University between January 1st, 2010 and March 31st, 2014. Patient characteristics, modified Glasgow Prognostic Score (mGPS), daily oxycodone dose, and reasons for opioid switching were retrospectively collected. ⋯ The results showed that the mGPS (odds ratio [OR], 2.358; 95% CI 1.379-4.031; P = 0.002), the reason for opioid switching (OR, 0.497; 95% CI, 0.298-0.828; P = 0.007) and equivalent oral morphine dose (OR, 1.700; 95% CI, 1.008-2.867; P = 0.046) were found to be significant predictors requiring higher conversion ratio in opioid switching. This study indicates that higher mGPS, poor pain control before switching and higher equivalent oral morphine dose are significant predictors of a need for higher conversion ratio in opioid switching from oral oxycodone to TDF. These results could contribute to the establishment of evidence-based medicine in cancer pain relief.
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This study aims to explore the analgesic effects of melatonin on post-herpetic neuralgia and its possible mechanism. ⋯ MT had significant analgesic effects in the treatment of PHN, and its mechanism was closely related with δopioid receptor, NO and MT2 receptor.
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To investigate the association between single nucleotide polymorphism (SNP) of peroxisome proliferator-activated receptors γ (PPAR γ) and additional gene-gene interactions on asthma risk. ⋯ Our results support an important association of rs1805192 and rs10865710 with asthma, and additional interaction among rs1805192, rs10865710 and rs709158.
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Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). ⋯ A higher percentage of patients in the preapneic oxygenation group had a Cormack-Lehane grade III or worse view (23.2% versus 11.8%). Anaesthesiology turns should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.
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Epidural injection of hydroxyethyl starch may be a suitable alternative for treatment of post-dural puncture headache (PDPH) if epidural blood patch is contraindicated. We reported eight consecutive female patients with accidental dural puncture (ADP), among whom prophylactic or therapeutic epidural injection of hydroxyethyl starch was performed. ⋯ Therapeutic epidural injection of hydroxyethyl starch 20 ml combined with sufentanil 5 μg were carried out once a day for 3 days in the patient whom relatively severe PDPH had occurred. Further prospective studies of epidural injection of hydroxyethyl starch in patients with ADP are required to create evidence-based clinical guidelines for safe practice.