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S. Liu A. E. Patanwala J. M. Naylor N. Levy R. Knaggs J. A. Stevens B. Bugeja D. Begley K. E. Khor E. Lau R. Allen S. Adie J. Penm 《Anaesthesia》2023,78(10):1237-1248
Modified-release opioids are often prescribed for the management of moderate to severe acute pain following total hip and knee arthroplasty, despite recommendations against their use due to increasing concerns regarding harm. The primary objective of this multicentre study was to examine the impact of modified-release opioid use on the incidence of opioid-related adverse events compared with immediate-release opioid use, among adult inpatients following total hip or knee arthroplasty. Data for total hip and knee arthroplasty inpatients receiving an opioid analgesic for postoperative analgesia during hospitalisation were collected from electronic medical records of three tertiary metropolitan hospitals in Australia. The primary outcome was the incidence of opioid-related adverse events during hospital admission. Patients who received modified with or without immediate-release opioids were matched to those receiving immediate-release opioids only (1:1) using nearest neighbour propensity score matching with patient and clinical characteristics as covariates. This included total opioid dose received. In the matched cohorts, patients given modified-release opioids (n = 347) experienced a higher incidence of opioid-related adverse events overall, compared with those given immediate-release opioids only (20.5%, 71/347 vs. 12.7%, 44/347; difference in proportions 7.8% [95%CI 2.3–13.3%]). Modified-release opioid use was associated with an increased risk of harm when used for acute pain during hospitalisation after total hip or knee arthroplasty. 相似文献
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Karhanová Marta Kalitová Jana Kovář Radim Schovánek Jan Karásek David Čivrný Jakub Hübnerová Petra Mlčák Petr Šín Martin 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2022,260(12):3977-3984
Graefe's Archive for Clinical and Experimental Ophthalmology - The purpose was to ascertain if any relation exists between the elevated intraocular pressure (IOP) in patients with... 相似文献
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European Journal of Epidemiology - With the rising use of machine learning for healthcare applications, practitioners are increasingly confronted with the limitations of prediction models that are... 相似文献
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Biniam Kidane MD MSc Ian J. Gerard MD PhD Jonathan Spicer MD PhD Julian O. Kim MD MSc BEng Pierre O. Fiset MD PhD Paul Wawryko MD Matthew J. Cecchini MD PhD Richard Inculet MD Bassam Abdulkarim MD PhD Dalilah Fortin MD Mehdi Qiabi MD MSc Gefei Qing MD Stephanie Enns BSc Bashir Bashir MBBS James Tankel MD Elliot Wakeam MD Andrew Warner MSc Neil Kopek MD Brian P. Yaremko MD MSc PEng George B. Rodrigues MD PhD Joanna M. Laba MD Melody Qu MD MPH Richard A. Malthaner MD MSc David A. Palma MD PhD 《Cancer》2023,129(18):2798-2807
Background
During coronavirus disease 2019 (COVID-19)–related operating room closures, some multidisciplinary thoracic oncology teams adopted a paradigm of stereotactic ablative radiotherapy (SABR) as a bridge to surgery, an approach called SABR-BRIDGE. This study presents the preliminary surgical and pathological results.Methods
Eligible participants from four institutions (three in Canada and one in the United States) had early-stage presumed or biopsy-proven lung malignancy that would normally be surgically resected. SABR was delivered using standard institutional guidelines, with surgery >3 months following SABR with standardized pathologic assessment. Pathological complete response (pCR) was defined as absence of viable cancer. Major pathologic response (MPR) was defined as ≤10% viable tissue.Results
Seventy-two patients underwent SABR. Most common SABR regimens were 34 Gy/1 (29%, n = 21), 48 Gy/3–4 (26%, n = 19), and 50/55 Gy/5 (22%, n = 16). SABR was well-tolerated, with one grade 5 toxicity (death 10 days after SABR with COVID-19) and five grade 2–3 toxicities. Following SABR, 26 patients underwent resection thus far (13 pending surgery). Median time-to-surgery was 4.5 months post-SABR (range, 2–17.5 months). Surgery was reported as being more difficult because of SABR in 38% (n = 10) of cases. Thirteen patients (50%) had pCR and 19 (73%) had MPR. Rates of pCR trended higher in patients operated on at earlier time points (75% if within 3 months, 50% if 3–6 months, and 33% if ≥6 months; p = .069). In the exploratory best-case scenario analysis, pCR rate does not exceed 82%.Conclusions
The SABR-BRIDGE approach allowed for delivery of treatment during a period of operating room closure and was well-tolerated. Even in the best-case scenario, pCR rate does not exceed 82%. 相似文献7.
Sánchez Restrepo Frank Hernández Valdivieso Alher Mauricio 《Journal of pharmacokinetics and pharmacodynamics》2022,49(4):411-428
Journal of Pharmacokinetics and Pharmacodynamics - The integration between physiologically-based pharmacokinetics (PBPK) models and pharmacodynamics (PD) models makes it possible to describe the... 相似文献
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Paula Pessin Fábrega Branisso Claudia Pinto Marques Souza de Oliveira Hilton Muniz Leão Filho Fabiana Roberto Lima Aritânia Sousa Santos Marcio Correa Mancini Maria Edna de Melo Flair José Carrilho Manoel de Souza Rocha Paul Clark Henrique José Pereira Branisso Cintia Cercato 《Annals of hepatology》2022,27(4):100707
IntroductionAlthough hyperferritinemia may reflect the inflammatory status of patients with non-alcoholic fatty liver disease (NAFLD), approximately 33% of hyperferritinemia cases reflect real hepatic iron overload.AimTo evaluate a non-invasive method for assessing mild iron overload in patients with NAFLD using 3T magnetic resonance imaging (MRI) relaxometry, serum hepcidin, and the expression of ferritin subunits.MethodsThis cross-sectional study assessed patients with biopsy-proven NAFLD. MRI relaxometry was performed using a 3T scanner in all patients, and the results were compared with iron content determined by liver biopsy. Ferritin, hepcidin, and ferritin subunits were assessed and classified according to ferritin levels and to siderosis identified by liver biopsy.ResultsA total of 67 patients with NAFLD were included in the study. MRI revealed mild iron overload in all patients (sensitivity, 73.5%; specificity, 70%). For mild (grade 1) siderosis, the transverse relaxation rate (R2*) threshold was 58.9 s?1 and the mean value was 72.5 s?1 (SD, 33.9), while for grades 2/3 it was 88.2 s?1 (SD, 31.9) (p < 0.001). The hepcidin threshold for siderosis was > 30.2 ng/mL (sensitivity, 87%; specificity, 82%). Ferritin H and ferritin L subunits were expressed similarly in patients with NAFLD, regardless of siderosis. There were no significant differences in laboratory test results between the groups, including glucose parameters and liver function tests.ConclusionsMRI relaxometry and serum hepcidin accurately assessed mild iron overload in patients with dysmetabolic iron overload syndrome. 相似文献
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Ganz Patricia A. Bandos Hanna Geyer Charles E. Robidoux André Paterson Alexander H. G. Polikoff Jonathan Baez-Diaz Luis Brufsky Adam M. Fehrenbacher Louis Parsons Ann W. Ward Patrick J. Provencher Louise Hamm John T. Stella Philip J. Carolla Robert L. Margolese Richard G. Shibata Henry R. Perez Edith A. Wolmark Norman 《Breast cancer research and treatment》2022,192(1):153-161
Breast Cancer Research and Treatment - The NSABP B-36 compared four cycles of doxorubicin and cyclophosphamide (AC) with six cycles of 5-fluorouracil, epirubicin, and cyclophosphamide (FEC-100) in... 相似文献