Swiss medical weekly
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Swiss medical weekly · May 2005
Randomized Controlled Trial Clinical TrialIncidence of contrast nephropathy in patients receiving comprehensive intravenous and oral hydration.
Contrast-induced nephropathy (CIN) remains a major complication of percutaneous coronary interventions (PCI) and a common cause of acute renal failure. The most effective preventive strategy is unknown. ⋯ Applying the combination of intravenous and oral volume supplementation results in a very low incidence of CIN following PCI. Hydration remains the cornerstone for the prevention of CIN.
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Swiss medical weekly · Aug 2001
Randomized Controlled Trial Clinical TrialWearing a noseclip improves nebulised aerosol delivery.
The efficiency of nebulised aerosol delivery is limited due to drug retained within the nebuliser, and due to a poor ratio between inspiratory drug delivery and expiratory drug loss. Several technical approaches have improved the ratio between inspiratory aerosol delivery and expiratory aerosol loss. In our pilot study we aimed to investigate if wearing a noseclip during inhalation therapy improves the inspiratory versus expiratory ratio and hence, improves nebulised aerosol delivery. ⋯ We have shown that aerosol delivery is increased due to an improved inspiratory versus expiratory ratio when wearing a noseclip.
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Swiss medical weekly · Feb 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of propacetamol and morphine in postoperative analgesia].
To compare the analgesic efficacy and tolerance of propacetamol and morphine, 80 patients in good clinical condition were included in a prospective, parallel, randomized double blind trial after elective surgery expected to elicit light to moderate postoperative pain. At the end of general anesthesia, 40 patients received 30 mg/kg propacetamol and 40 0.2 mg/kg morphine, as a 15-min intravenous infusion. The groups were similar for age, weight and duration of anesthesia. ⋯ No significant differences were observed in blood oxygen saturation, blood pressure, heart rate, body temperature and vigilance evaluated by the trailmaking test. Nausea was present in 4 cases under propacetamol and 3 under morphine, and pruritus in 2 and 7 cases, respectively. In conclusion, propacetamol may represent an alternative to morphine for pain prevention after mildly to moderately painful surgery in situations where the use of opioids is unsuitable.
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Swiss medical weekly · Aug 1996
Randomized Controlled Trial Clinical Trial[Colonic preparation with sodium phosphate. Prospective, randomized, placebo-controlled double blind study with various antiemetics].
The well established bowel cleansing method using a polyethylene glycol-based solution (Fordtran) is limited by the necessity of large volume intake, which proves difficult for many patients. Therefore, a new method using small volumes (2 x 90 ml) of oral sodium phosphate is employed more and more frequently. Its only disadvantage is the occurrence of considerable nausea or occasional vomiting in about 25% of patients. To ascertain whether nausea could be reduced, 426 patients were given an antiemetic (ondansetron, metoclopramide, cisapride) or placebo on a randomized, double-blind basis, one hour before sodium phosphate intake. ⋯ sodium phosphate was well tolerated in 69.2% of the patients on placebo, 73.6% on cisapride, 76.5% on metoclopramide and 80.4% on ondansetron. Taking all four groups together, male patients exhibited much better tolerance (86.1%) than females (66.1%). Severe nausea and/or emesis was noted in 22.4% of patients on placebo, 21.7% on cisapride, 17% on metoclopramide and 14% on ondansetron. In over 90% of patients colon cleansing was rated as good to very good. This was largely independent of the severity of nausea. 129 patients who had undergone former polyethylene glycol-based lavage judged sodium phosphate to be more tolerable and easier to complete. Considering known contraindications (symptomatic congestive heart failure and/or renal failure), no serious adverse event was noted in any of the 426 patients investigated. In accordance with several recent studies, we consider sodium phosphate solution at present the procedure of choice for colon cleansing. Compared to Fordtran, patient acceptance is far better and cleansing quality superior. Routine antiemetic comedication for reducing possible nausea/vomiting is not worthwhile. On the other hand, this study confirms our former impression of enhanced colon cleansing after administration of an additional mild laxative before sodium phosphate, without interfering with patient acceptance.
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Swiss medical weekly · Sep 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of the efficacy of omeprazole/bismuth subcitrate or triple therapy in Helicobacter pylori gastritis. A prospective controlled study].
In a controlled, prospective, randomized trial, 10 patients with Helicobacter pylori positive gastritis were treated either with triple therapy (tetracycline, ornidazole, bismuth subcitrate; T, Or, CBS), or omeprazole/CBS (O/CBS) to test the eradication rate of each treatment, its effect on gastritis and meal stimulated gastrin release. ⋯ (1) Triple therapy is also successful in short term treatment in up to 80% of patients with HP gastritis and improves gastritis activity. (2) The combination O/CBS failed to eradicate HP in all treated patients. (3) The 13C-urea breath test and HP serology are reliable non-invasive parameters during follow-up. (4) Normalization of meal stimulated gastrin release after eradication of HP supports the hypothesis that HP induces increased gastrin release and hyperacidity.