Validity of the Central Sensitization Inventory (CSI) through Rasch analysis in patients with knee osteoarthritis

Clinical Rheumatology - Central sensitization (CS) is a known contributor to chronic pain in people with knee osteoarthritis (KOA) and is commonly measured by psychophysical testing or...     

Generalisierter Krampfanfall während der Anlage einer axillären Plexusblockade

Die Anaesthesiologie - Eine junge Patientin erleidet während der Anlage einer axillären Plexusblockade einen generalisierten Krampfanfall. Die Mechanismen, im Wesentlichen die vermutlich...     

Influence of Classroom-Level Factors on Implementation Fidelity During Scale-up of Evidence-Based Interventions

Prevention Science - As evidence-based interventions (EBIs) become more widely disseminated, fidelity of implementation (FOI) often wanes. This study explores the association between FOI and...     

Nebenwirkungen bei Immuncheckpointinhibitoren (ICI)

best practice onkologie - Die Einführung von Immuncheckpointinhibitoren (ICI) veränderte die Behandlung und die Prognose zahlreicher Tumorerkrankungen entscheidend. Grundsätzlich ist...     

Effects of Single-Dose Preemptive Pregabalin and Intravenous Ibuprofen on Postoperative Opioid Consumption and Acute Pain after Laparoscopic Cholecystectomy

Purpose: Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ?v ibuprofen. Methods: 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ?v ibuprofen before surgery. Postoperative fentanyl consumption, additional analgesia requirements and PACU stay were recorded. Postoperative analgesia was performed with patient-controlled IV fentanyl. Results: VAS scores in the group PI were statistically lower at PACU, 1and 2 hours at rest, at PACU, 1, 2, 4, 12 and 24 hours on movement compared to the group P (P < 0.05). Opioid consumption was statistically significantly higher in the group P compared to the group PI (130.17 ± 60.27 vs 78.45 ± 60.40 μq, respectively, P < 0.001) and reduced in the 4th 24 hours by 55% in group PI. Rescue analgesia usage was statistically significantly higher in the group P than in the group PI (16/29 vs 7/29, respectively, P < 0.001). Four patient in the group PI did not need any opioid drug. Besides, PACU stay was shorter in the group PI than the group P (10.62 ± 2.38 vs 15.59 ± 2.11 min, respectively, P < 0.001). Conclusion: Preemptive pregabalin plus ?v ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption. This multimodal analgesic aproach generated lower pain scores in the postoperative period.     

Glucose metabolism in patients with psoriasis

Large epidemiological (population-based) studies conclude that psoriasis increases the risk of type 2 diabetes (T2D). Our primary objective was to find out whether data from clinical studies support the notion of shared disease mechanisms in psoriasis and T2D. For this purpose, we reviewed clinical studies investigating glucose metabolism in patients with psoriasis. We also present existing theories of how psoriasis might lead to type 2 diabetes. Twenty-six clinical studies reporting on insulin resistance, glucose tolerance or insulin secretion were eligible for review. Less than half of the studies showed results that suggest a defective glucose metabolism in patients with psoriasis. Overall, the studies lacked information on how known risk-factors for type 2 diabetes had been taken into account in the study. Furthermore, research methods varied and in all but one study, they might not have been appropriate to detect early and subtle defects in glucose metabolism. The results of clinical studies investigating glucose metabolism in patients with psoriasis are conflicting and presently it seems presumptuous to firmly conclude that patients with psoriasis share disease mechanisms with people with type 2 diabetes. However, seen in conjunction with the epidemiological literature and the proposed theories of shared disease mechanisms, there is ample basis for further research in this area. New studies using sound methods and elaborate research techniques are needed to learn more about glucose metabolism in patients with psoriasis.