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1.
Background
Total knee arthroplasty is a treatment option for debilitating arthritis. In the postoperative period, patients experience moderate to severe pain affecting the rehabilitation, hospital stay, and patient satisfaction. This study aims at utilizing current best evidence to determine whether adductor canal block (ACB) or periarticular injection (PAI) is a better modality for managing short-term postoperative pain and opioid consumption.Methods
Embase, MEDLINE, HealthStar, Emcare, and PubMed were searched for randomized controlled trials from 1946 to August 2018, for literature addressing the comparison of ACB and PAI for pain management in the setting of total knee arthroplasty. A systematic review and meta-analysis were performed.Results
Six studies were included in our meta-analysis. When examining the combined visual analog scale (VAS) pain values for each group, analysis demonstrated greater reduction in scores for the PAI group, and the difference was statistically significant (P = .001). When comparing the VAS scores of subgroups analyzed at specific periods in time, there was a trend toward lower VAS scores in subgroups analyzed at 24 hours and 48 hours postoperatively (at rest and at movement) in the PAI group. Overall opioid consumption was lower in the PAI group, with demonstrated statistical significance (P = .03). When comparing the postoperative subgroups, there was a trend toward decreased opioid use in the PAI group, with 13.25% less opioid use at 48 hours and 9.5% less opioid use at 24 hours.Conclusion
PAI could significantly improve postoperative pain and opioid consumption when compared with ACB. Additional, high-quality studies are required to further address this topic. 相似文献2.
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Thalidomide has been used as an effective treatment for prurigo nodularis (PN) with a median dose of 200 mg, but the risk of peripheral neuropathy precludes long-term use. We analysed the efficacy of low-dose thalidomide (< 100 mg) in 17 patients with recalcitrant PN. Patients were initiated on thalidomide 50 mg on alternate days, and the dose was increased (doubled) in a stepwise manner, if needed, until a ≥ 50% reduction in score (partial response; PR) on a visual analogue scale (VAS) was achieved. Thalidomide then was continued at the same dose for 4 weeks to achieve ≥ 90% decrease in VAS score; if this was not achieved, the dose was increased to a maximum of 100 mg and continued until complete resolution of lesions (complete response; CR). Four patients discontinued thalidomide due to adverse effects. Four patients achieved PR, while 9 patients (n = 2 with 50 mg, n = 7 with 100 mg) achieved CR. No patient developed neuropathy. In addition, complete responders achieved an earlier ≥ 50% reduction in VAS score. Two patients relapsed after 12 months but responded to thalidomide 50 mg. 相似文献
4.
Arunaloke Chakrabarti Prashant Sood Shivaprakash M. Rudramurthy Sharon Chen Joseph Jillwin Ranganathan Iyer Ajanta Sharma Belgode Narasimha Harish Indranil Roy Anupma J. Kindo Deepinder Chhina Jayanthi Savio Deepak Mendiratta Malini R. Capoor Shukla Das Anita Arora Jagdish Chander Immaculata Xess Appalaraju Boppe Ujjwayini Ray Ratna Rao Vandana Kalwaje Eshwara Sangeeta Joshi Atul Patel Raman Sardana Anjali Shetty Umabala Pamidimukkala for the SIHAM Candidemia Network 《Mycoses》2020,63(11):1149-1163
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Arunaloke Chakrabarti Prashant Sood Shivaprakash M. Rudramurthy Sharon Chen Harsimran Kaur Malini Capoor Deepinder Chhina Ratna Rao Vandana Kalwaje Eshwara Immaculata Xess Anupama J. Kindo P. Umabala Jayanthi Savio Atul Patel Ujjwayini Ray Sangeetha Mohan Ranganathan Iyer Jagdish Chander Anita Arora Raman Sardana Indranil Roy B. Appalaraju Ajanta Sharma Anjali Shetty Neelam Khanna Rungmei Marak Sanjay Biswas Shukla Das B. N. Harish Sangeeta Joshi Deepak Mendiratta 《Intensive care medicine》2015,41(2):285-295
7.
Fedor A. Platonov Kathrin Tyryshkin Dmitriy G. Tikhonov Tatyana S. Neustroyeva Tatyana M. Sivtseva Natalya V. Yakovleva Valerian P. Nikolaev Oksana G. Sidorova Sardana K. Kononova Lev G. Goldfarb Neil M. Renwick 《Neurogenetics》2016,17(3):179-185
Spinocerebellar ataxia type 1 (SCA1) is the major and likely the only type of autosomal dominant cerebellar ataxia in the Sakha (Yakut) people of Eastern Siberia. The prevalence rate of SCA1 has doubled over the past 21 years peaking at 46 cases per 100,000 rural population. The age at death correlates closely with the number of CAG triplet repeats in the mutant ATXN1 gene (r = ?0.81); most patients with low-medium (39–55) repeat numbers survived until the end of reproductive age. The number of CAG repeats expands in meiosis, particularly in paternal transmissions; the average total increase in intergenerational transmissions in our cohort was estimated at 1.6 CAG repeats. The fertility rates of heterozygous carriers of 39–55 CAG repeats in women were no different from those of the general Sakha population. Overall, the survival of mutation carriers through reproductive age, unaltered fertility rates, low childhood mortality in SCA1-affected families, and intergenerational transmission of increasing numbers of CAG repeats in the ATXN1 gene indicate that SCA1 in the Sakha population will be maintained at high prevalence levels. The low (0.19) Crow’s index of total selection intensity in our SCA1 cohort implies that this mutation is unlikely to be eliminated through natural selection alone. 相似文献
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Soumadri Samanta Sunil Kumar V. R. Battula Arpna Jaryal Neha Sardana Kamalakannan Kailasam 《RSC advances》2020,10(50):29633
Metal-free organic polymer photocatalysts have attracted dramatic attention in the field of visible light-induced hydrogen evolution reaction (HER). Herein, we showed a polymeric O-linked heptazine polymer (OLHP) decorated with S, N co-doped graphene quantum dots (S,N-GQDs) as a photosensitizer to generate hydrogen upon quantum dot sensitization. Both of these heptazine-based systems show effective photosensitization with strong π–π interactions and enhanced photocatalytic H2 generation (24 times) as metal-free systems. Electrochemical impedance and optical measurements show effective charge transfer kinetics with decreased charge recombination, which is responsible for the enhanced photocatalytic activity. As a result, a significant high apparent quantum yield (AQY) with highest value of 10.2% was obtained for our photocatalyst OLHP/S,N-GQD10.A polymeric O-linked heptazine polymer (OLHP) decorated with S, N co-doped graphene quantum dots (S,N-GQDs) as a photosensitizer to utilize visible light (λ > 420 nm) for hydrogen generation. 相似文献