Safety and Efficacy of Single-Dose Ketorolac for Postoperative Pain Management After Primary Palatoplasty: A Prospective Cohort Study With Historical Controls

2021 ◽  
pp. 105566562110128
Author(s):  
Jason R. Stein ◽  
Esperanza Mantilla-Rivas ◽  
Marudeen Aivaz ◽  
Md Sohel Rana ◽  
Ishwarya Shradha Mamidi ◽  
...  
Keyword(s):  
Single Dose ◽  
Postoperative Pain Management ◽  
Postoperative Hemorrhage ◽  
Bleeding Complications ◽  
Control Group ◽  
Study Group ◽  
Safety And Efficacy ◽  
Opioid Dose ◽  
Historical Controls

Objective: To analyze safety and efficacy of single-dose ketorolac after primary palatoplasty (PP). Design: Consecutive cohort of patients undergoing PP, comparing to historical controls. Setting: A large academic children’s hospital. Patients, Participants: A consecutive cohort of 111 patients undergoing PP (study n = 47) compared to historical controls (n = 64). Interventions: All patients received intraoperative acetaminophen, dexmedetomidine, and opioids while the study group received an additional single dose of ketorolac (0.5 mg/kg) at the conclusion of PP. Main Outcome Measures: Safety of ketorolac was measured by significant bleeding complications and need for supplementary oxygen. Efficacy was assessed through bleeding, Face Legs Activity Cry Consolability (FLACC) scale, and opioid dose. Results: Length of stay was similar for both groups (control group 38.5 hours [95% CI: 3.6-43.3] versus study group 37.6 hours [95% CI: 31.3-44.0], P = .84). There were no significant differences in all postoperative FLACC scales. The mean dose of opioid rescue medication measured as morphine milligram equivalents did not differ between groups ( P = .56). Significant postoperative hemorrhage was not observed. Conclusions: This is the first prospective study to evaluate the safety and efficacy of single-dose ketorolac after PP. Although lack of standardization between study and historical control groups may have precluded observation of an analgesic benefit, analysis demonstrated a single dose of ketorolac after PP is safe. Further investigations with more patients and different postoperative regimens may clarify the role of ketorolac in improving pain after PP.

scholarly journals The Role of CD68 (+) Histiocytic Macrophages in Nasal Polyp Development

2020 ◽  
Author(s):  
Nuray Bayar Muluk ◽  
Osman Kürşat Arikan ◽  
Pınar Atasoy ◽  
Rahmi Kiliç ◽  
Eda Tuna Yalçinozan
Keyword(s):  
Nasal Cavity ◽  
Nasal Polyp ◽  
Nasal Polyps ◽  
Deep Layer ◽  
Ethmoid Sinus ◽  
Adult Patients ◽  
Control Group ◽  
Study Group ◽  
Deep Layers

Abstract Objectives The aim of this study was to investigate the role of CD68 (+) histiocytic macrophages (H-M) in the nasal polyp pathogenesis. Materials and Methods The study group consisted of 24 adult patients with nasal polyposis. The control group consisted of 11 adult patients without nasal polyps. A total of 36 nasal polyp samples (10-nasal cavity, 10-maxillary sinus, and 16-ethmoid sinus) from the study group and 11 inferior turbinate samples from the control group were analyzed by immunohistochemical staining, with monoclonal antibodies against CD68 (+) H-M. Results CD68 positivity was significantly higher than the control group in the subepithelial (SE) layer of the ethmoid sinus, and deep layers of nasal cavity, maxillary, and ethmoid sinuses. In SE and deep layers of ethmoid and maxillary sinuses, CD68 positivity was significantly higher than that of the epithelial layer. In the deep layer, histiocytic macrophages tended to gather around eosinophils. Conclusion The high numbers of CD68 (+) histiocytic macrophages mainly located in deep layer of lamina propria may be responsible for the phagocytosis of eosinophils within the polyp tissue. Therefore, it may be concluded that increased macrophages in nasal polyps do not trigger the growth of nasal polyps. Instead, they may serve to reduce the number of eosinophils in already-developed nasal polyps.

Questioning Role of Hypochloremia in Bronchopulmonary Dysplasia

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1173-1173
Author(s):  
JEFFREY M. PERLMAN ◽  
JEFF DAWSON
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Metabolic Alkalosis ◽  
Complex Disease ◽  
Disease Process ◽  
Control Group ◽  
Study Group

In Reply.— We appreciate the interest in our report published in Pediatrics (1986;77:212-216). The three letters raise similar questions, and in response we would like to make three points. First, including the two infants in the control group who died with the infants in the study group still resulted in significant differences between the two groups regarding duration of furosemide (Lasix) therapy, hypochloremia, or metabolic alkalosis (P > .001). Second (as noted in our discussion), bronchopulmonary dysplasia is a complex disease process.

scholarly journals Occurrence of urogenital mycoplasmas in men with the common genitourinary diseases

2021 ◽  
Author(s):  
Dominika Smolec ◽  
Alicja Ekiel ◽  
Piotr Kłuciński ◽  
Jan Kawecki
Keyword(s):  
Infectious Complications ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Study Group ◽  
Immunocompromised Patients ◽  
Healthy Men ◽  
The Common ◽  
Estimate Prevalence ◽  
Positive Results

Abstract Many serious and fatal infections with urogenital mycoplasmas in immunocompromised patients have been reported. M. genitalium is recognized as a cause of male urethritis and other common genitourinary diseases. The aim of the study was to estimate prevalence of urogenital mycoplasmas which can cause complications in men with common genitourinary diseases. Study included 85 men with genitourinary tract carcinoma (n = 35), urolithiasis (n = 36), and BPH (benign prostatic hyperplasia) (n = 14). The control group consisted of 50 healthy men. FVU (first void urine) samples were examined by PCR for the presence of urogenital mycoplasmas DNA. Occurrence of urogenital mycoplasmas was significantly more common in study group compared with control 24/85 (28.2%) and 7/50 (14%), respectively (p = 0.05). In men with urolithiasis, positive results for mycoplasmas DNA were significantly more frequent than in control: 33.3% vs. 14% (p < 0.05). In patients with urolithiasis DNA of U. urealyticum was most often found, while in the genitourinary carcinoma and BPH groups, U. parvum was more frequent. Incidence of M. fermentans was also significantly higher in the urolithiasis group vs. control (p = 0.03). A higher percentage of positive results for urogenital mycoplasma DNA in study group has been found. Further studies are required to confirm the role of urogenital mycoplasmas in the development of infectious complications among patients with urolithiasis, genitourinary carcinoma, and BPH.

scholarly journals The Role of P53 in Sepsis-Induced Cardiomyopathy

2021 ◽  
Vol 26 (3) ◽  
pp. 45-47
Author(s):  
Peter Michael Reil ◽  
Teodor Traian Maghiar ◽  
Karlheinz Seidl ◽  
Claudia Teodora Judea Pusta ◽  
Ciprian Borza ◽  
...  
Keyword(s):  
Cardiac Tissue ◽  
Medical Problem ◽  
Statistical Correlation ◽  
Control Group ◽  
Study Group ◽  
Septic Cardiomyopathy ◽  
Pulmonary Infections ◽  
P53 Expression ◽  
The Difference

Abstract Septic cardiomyopathy remains a difficult medical problem to manage in critically ill patients. With all currently available therapeutic options, the mortality rate in these patients remains high. Our study included 29 patients diagnosed clinically with sepsis. A control group was used to compare the results. In all patients, p53 expression was assessed in cardiac tissue obtained from these patients and a statistical correlation was made with clinical data. The different expression rates of p53 do not correlate with patient’s age, having appropriate means in years, but with an increasing tendency with increasing expression (p=0.2110). The pulmonary infections are responsible for the majority of the septic state in the study group (over 55%). The difference between the infection sites is statistically significant (p<0.0001).

scholarly journals Role of per-operative milrinone on pulmonary hypertension having mitral valve replacement.

2021 ◽  
Vol 28 (01) ◽  
pp. 120-124
Author(s):  
Shahbaz Ahmad Khilji ◽  
Shuja Tahir ◽  
Shahid Abbas
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Nyha Class ◽  
Control Group ◽  
Study Group ◽  
Replacement Surgery ◽  
Valve Replacement Surgery

Objective: To determine the role of perioperative milrinone on pulmonary hypertension in patients with mitral valve disease undergoing mitral valve replacement surgery. Study Design: Randomized Control Trial. Setting: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad. Period: June 2019 to June 2020. Material & Methods: A total of 80 patients with mitral valve disease who underwent mitral valve replacement were included. The patients were divided into a control group of 40, who were not administered milrinone, and a study group of 40 who received milrinone perioperatively. TVPG, LVEF and NYHA class were recorded preoperatively and postoperatively and were compared. Results: In the study group, postoperative LVEFs and NYHA class were not statistically significant in both groups while postoperative TVPG was significantly lower in study group as compare to control group and is statistically significant (P<0.001). Conclusion: Our study concludes that milrinone can be used as an effective therapy to reduce pulmonary pressure in patients with pulmonary hypertension undergoing mitral valve replacement surgery.

scholarly journals The Impact of Pre-emptive Large Dose of Methylprednisolone Combined With Gabapentin on Pain Treatment and Convalescence After Total Knee Arthroplasty in Elderly. A Randomized Control Study

2021 ◽  
Author(s):  
Henryk Liszka ◽  
Małgorzata Zając ◽  
Artur Gądek
Keyword(s):  
Total Knee Arthroplasty ◽  
Single Dose ◽  
Knee Arthroplasty ◽  
Opioid Analgesic ◽  
Control Group ◽  
Study Group ◽  
Intensity Level ◽  
Old Patients ◽  
Total Knee ◽  
The Impact

Abstract Background The aim of the study was to assess whether administration of gabapentin and methylprednisolone as “pre-emptive analgesia” in a group of patients above 65 years of age would be effective in complex pain management therapy following total knee arthroplasty (TKA). Material and Methods One hundred seventy, above 65 years old patients were qualified for the study, and 10 patients were excluded due to clinical situation. One hundred sixty patients were double-blind randomized into two groups: the study (eighty patients) and controls (eighty patients). The study group received as “pre-emptive” analgesia a single dose of 300 mg oral gabapentin and 125 mg intravenous methylprednisolone, while the others placebo. Perioperatively, all the patients received opioid and nonopioid analgesic agents calculated for 1 kg of body weight. We measured the levels of inflammatory markers (leukocytosis, C-reactive protein - CRP), pain intensity level at rest (numerical rating scale - NRS), the life parameters and all complications. Results Following administration of gabapentin and methylprednisolone as “pre-emptive” analgesia CRP values being lower on all postoperative days ( 1, 2 days - p<0,00001, 3 day – p=000538), leukocytosis on day 2 (p<0,0086) and 3 (p<0,00042), the NRS score at rest 6, 12 (p<0,000001), 18 (p<0,00004) and 24 (p=0,005569) hours postoperatively . Methylprednisolone with gabapentin significantly decreased the dose of parenteral opioid preparations (p=0,000006). The duration time of analgesia was significantly longer in study group (p<0,000001). No infectious complications were observed; in the control group, one patient manifested transient ischaemic attack (TIA). Conclusion The use of gabapentin and methylprednisolone at a single dose decreases the level of postoperative pain on the day of surgery, the dose of opioid analgesic preparations, the level of inflammatory parameters without infectious processes.

Cide-A Gene Expression in Patients with Obesity Qualified for Endovascular Treatment of Abdominal Aorta Aneurysm

2015 ◽  
Vol 86 (10) ◽  
Author(s):  
Marcin Feldo ◽  
Janusz Kocki ◽  
Jan Feldo ◽  
Sylwia Łukasik ◽  
Jacek Bogucki ◽  
...  
Keyword(s):  
Gene Expression ◽  
Endovascular Aneurysm Repair ◽  
The Body ◽  
Control Group ◽  
Study Group ◽  
Aorta Aneurysm ◽  
Group Play ◽  
Aneurysm Repair ◽  
Adipose Tissue Cells

Abstractgene and the genes of LRP group play a key role in the regulation of the body weight and lipid metabolism in mammals.was to define the role of. The study group consisted of 38 subjects, including 27 men and 11 women qualified for endovascular aneurysm repair (EVAR). The subjects with abdominal aortic aneurysm were enrolled in the study group, depending on the body mass index (BMI); in obese patients (BMI > 30). The control group (n = 16) included subjects without lipid disorders. One-step isolation of RNA from lymphocytes and adipose tissue cells was performed using the modified TRI method by Chomc-zynski and Sacchi, and then the gene expression was tested by real-time PCR.. The highest mean relative of the gene expression for. Due to the important role of the

scholarly journals Activity of Proteolytic Enzymes and Level of Cystatin C in the Peripartum Period

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Anna Cyganek ◽  
Aleksandra Wyczalkowska-Tomasik ◽  
Patrycja Jarmuzek ◽  
Barbara Grzechocinska ◽  
Zoulikha Jabiry-Zieniewicz ◽  
...  
Keyword(s):  
Cystatin C ◽  
Cathepsin B ◽  
Proteolytic Enzymes ◽  
Late Pregnancy ◽  
Control Group ◽  
Study Group ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Peripartum Period

Objectives. The aim of the study was to evaluate the activity of cathepsin B, collagenases, trypsin, and plasmin and concentration of cystatin C in serum of healthy pregnant women in peripartum period.Study Design. The study group included 45 women in uncomplicated pregnancies. Blood samples were collected in four time points. Enzyme activity was measured by spectrofluorometric method. The level of cystatin C was measured using immunonephelometric method.Results. Mean activity of cathepsin B and the level of serum cystatin C were significantly higher in the study group. Collagenase activity was significantly lower in the study group than the control group. No differences in collagenase, plasmin, and trypsin activity on each day of the peripartum period were found.Conclusion. High activity of cathepsin B and increased level of cystatin C are typical for women in late pregnancy. Those levels significantly decrease after delivery which can be associated with potential role of those markers in placental separation. The insignificant changes of cystatin C level in the peripartum period seem to exclude the possibility of using cystatin C as a marker for renal insufficiency in the peripartum period but additional research is necessary to investigate the matter further.

scholarly journals The Role of Coconut Oil in Treating Patients Affected by Plaque-Induced Gingivitis: A Pilot Study

2020 ◽  
Vol 14 (04) ◽  
pp. 558-565
Author(s):  
Francesca Ripari ◽  
Federica Filippone ◽  
Giulia Zumbo ◽  
Francesco Covello ◽  
Francesca Zara ◽  
...  
Keyword(s):  
Coconut Oil ◽  
Mean Value ◽  
Plaque Formation ◽  
Control Group ◽  
Study Group ◽  
Clinical Parameters ◽  
Significant Drop ◽  
Significance Level ◽  
Student’S T

Abstract Objectives The aim of the study was to evaluate the coconut oil pulling efficacy as adjuvant in reducing plaque formation and in treating plaque-induced gingivitis. Materials and Methods A sample of 20 patients was divided into two groups: a study and a control group. In the study group, coconut oil, in form of mouthwash, was administered to a sample of patients affected by gingivitis, aged between 18 and 35. The protocol established a daily application of the product for 30 days, where clinical parameters for plaque formation and gingivitis—plaque index (PI), bleeding index (BI)—will be evaluated during the recalls on a specific periodontal chart. The control group did not associate a coadjuvant to the normal daily oral health procedures and the same clinical parameters were evaluated at t0 and after 30 days (t1). The data were statistically analyzed using Student’s t-test, establishing the significance level as p < 0.05. Results PI and BI decreased in both groups, with a more relevant and significant drop in the study group, from a mean value of PI of 58.0 to 19.3 and a mean value of BI of 33.5 to 5.0. In the control group, the values decreased, respectively, from 53.9 to 29.1 for PI, and from 33.5 to 16.2. Furthermore, no significant side effect was reported during coconut oil pulling therapy. Conclusions The collected data showed significant and promising improvements in reducing plaque formation and gingivitis. However, further researches have to be performed to have more consistent and statistically significant data on larger samples and to fully understand the mechanisms of action and effectiveness.

PROLACTIN IN MAINTENANCE OF THE CORPUS LUTEUM OF EARLY PSEUDOPREGNANCY IN THE GOLDEN HAMSTER

1981 ◽  
Vol 90 (2) ◽  
pp. 145-150 ◽  
Author(s):  
K. H. HARRIS ◽  
B. D. MURPHY
Keyword(s):  
Single Dose ◽  
Corpus Luteum ◽  
Golden Hamster ◽  
Peripheral Blood ◽  
Plasma Levels ◽  
Progesterone Level ◽  
Control Group ◽  
Blood Samples

The role of prolactin in the maintenance of the corpus luteum of pseudopregnancy was studied in the golden hamster. Nine groups of seven to fourteen animals each received 1 mg bromocriptine at 11.00 h on days 1, 2 or 3 of pseudopregnancy (three groups for each day). On each day of treatment with bromocriptine, one group of hamsters was injected with bovine prolactin 4 h before bromocriptine, and one group received prolactin 4 h before bromocriptine for three consecutive days following treatment with bromocriptine. One group received bromocriptine only. These nine groups were compared with a control group of animals given 0·85% saline instead of bromocriptine and prolactin. Peripheral blood samples were taken from all hamsters at 11.00 h on days 3, 4, 5 and 6 of pseudopregnancy and plasma levels of progesterone were determined by radioimmunoassay. Luteolysis, indicated by a decline in progesterone level by 24 or 48 h after treatment with bromocriptine, occurred in all hamsters given bromocriptine alone, whether it was administered on day 1, 2 or 3. Pretreatment with a single dose of prolactin did not mitigate the bromocriptine-induced fall in progesterone. In the majority of cases, pretreatment with prolactin plus daily doses of prolactin maintained the progesterone at levels not different from saline-treated hamsters. These data suggest that prolactin is a necessary luteotrophin during early pseudopregnancy without which luteolysis ensues.

Sign in / Sign up

Export Citation Format

Share Document