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Items 1 - 13 of 13 |
One page. |
Comment on:
Assessment of patients with chest pain.
Reilly BM, Evans AT.
Publication Types:
PMID: 15313759 [PubMed - indexed for MEDLINE]
Comment on:
Assessment of patients with chest pain.
Workman S.
Publication Types:
PMID: 15313758 [PubMed - indexed for MEDLINE]
Comment on:
Assessment of patients with chest pain.
Johnson JR.
Publication Types:
PMID: 15313757 [PubMed - indexed for MEDLINE]
Comment on:
Chest pain relief by nitroglycerin.
Evans AT, Reilly BM.
Publication Types:
PMID: 15313756 [PubMed - indexed for MEDLINE]
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The effect of coinduction with midazolam on propofol injection pain.
Galvez-Escalera I, Thorpe CM.
Publication Types:
PMID: 15318476 [PubMed - in process]
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Shoulder pain after gynaecological laparoscopy caused by arm abduction.
Kojima Y, Yokota S, Ina H.
Publication Types:
PMID: 15318475 [PubMed - in process]
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Role of spinal 5-HT(1A) receptors in morphine analgesia and tolerance in rats.
Bardin L, Colpaert FC.
Centre de Recherche Pierre-Fabre, 17 Avenue Jean Moulin, Castres Cedex F-81106, France. laurent.bardin@pierre-fabre.com
We here studied the involvement of spinally located 5-HT(1A) and opioid receptors, in the paradoxical effects that their activation can produce on nociception. Intrathecal (i.t.) injection of the 5-HT(1A) receptor agonist 8-hydroxy-2-[di-n-propylamino] tetralin (8-OH-DPAT) (1-10 microg) induced analgesic effects in the formalin model of tonic pain whereas in the paw pressure test, it decreased the vocalization threshold. In this latter test, i.t. 8-OH-DPAT also markedly reduced the analgesic effect of systemic morphine (5-10 mg/kg, s.c.). At 10 microg, 8-OH-DPAT totally abolished the effect of 5 mg/kg of morphine; this inhibitory effect was antagonized by pre-treatment with 0.63 mg/kg of the 5-HT(1A) antagonist WAY-100635 (N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]-ethyl]-N-(2-pyridinyl)-cyclohexanecarboxamide-trihydrochloride). In contrast, the i.t. injection of WAY-100635 (1-10 microg) dose-dependently potentiated the antinociceptive activity of a dose of morphine (2.5 mg/kg, s.c.). Furthermore, WAY-100635 (10 microg, i.t.) potentiated morphine analgesia in morphine-tolerant rats. These findings demonstrate that 5-HT(1A) receptor agonists can act in the spinal cord to produce both hyper- and hypo-algesic effects and play a major role in the opioid analgesia and tolerance.
PMID: 15109976 [PubMed - indexed for MEDLINE]
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Acetaminophen (paracetamol) improves pain and well-being in people with advanced cancer already receiving a strong opioid regimen: a randomized, double-blind, placebo-controlled cross-over trial.
Stockler M, Vardy J, Pillai A, Warr D.
Department of Medicine and School of Public Health, NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia. stockler@med.usyd.edu.au
PURPOSE: To determine whether adding regular acetaminophen (paracetamol) could improve pain and well-being in people with advanced cancer and pain despite strong opioids. PATIENTS AND METHODS: Participants took acetaminophen for 48 hours and placebo for 48 hours. The order (acetaminophen or placebo first) was randomly allocated. Pain was the primary outcome. Preferences, number of opioid breakthrough doses, overall well-being, nausea and vomiting, drowsiness, constipation, and cold sweats were secondary outcomes. Patients rated themselves daily with visual analog scales (VAS) and a verbal numeric scale (VNS) for pain, all scaled from 0 to 10. RESULTS: Thirty patients completed the trial. The oral opioid was morphine in 23 patients and hydromorphone in seven patients. The median daily opioid dose in oral morphine equivalents was 200 mg (range, 20 to 2,100 mg). Nonsteroidal anti-inflammatory drugs, corticosteroids, or both were used by 16 patients. Pain and overall well-being were better for patients receiving acetaminophen than for those receiving placebo. The mean difference was 0.4 (95% CI, 0.1 to 0.8; P =.03) in VNS for pain, 0.6 (95% CI, -0.1 to 1.3; P =.09) in VAS for pain, and 0.7 (95% CI, 0.0 to 1.4; P =.05) in VAS for overall well-being. More patients preferred the period they took acetaminophen (n = 14) than the period they took placebo (n = 8), but many had no preference (n = 8). There were no differences in the other outcomes. CONCLUSION: Acetaminophen improved pain and well-being without major side effects in patients with cancer and persistent pain despite a strong opioid regimen. Its addition is worth considering in all such patients.
Publication Types:
- Clinical Trial
- Multicenter Study
- Randomized Controlled Trial
PMID: 15310785 [PubMed - indexed for MEDLINE]
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Dose-response relationship between opioid use and adverse effects after ambulatory surgery.
Zhao SZ, Chung F, Hanna DB, Raymundo AL, Cheung RY, Chen C.
Global Health Outcomes Research, Pfizer, Inc., Peapack, New Jersey, USA.
This health outcomes analysis based on data from a randomized, double-blind, placebo-controlled trial determined dose-response relationship between opioid use and related symptoms. All patients received intravenous fentanyl on demand for pain predischarge, and oral acetaminophen 500 mg/hydrocodone 5 mg every 4-6 hours as needed postdischarge for up to 7 days postsurgery. Patients completed an opioid-related Symptom Distress Scale (SDS) questionnaire every 24 hours postdischarge for 7 days, which assessed 12 opioid-related symptoms by 3 ordinal measures: frequency, severity, and bothersomeness. Clinically meaningful events (CMEs) were defined based on the responses to this questionnaire. Opioid use was converted to morphine equivalent dose (MED). The dose-response relationship between composite SDS scores and MED on Day 1, on Days 0 and 1, and on Days 1-4, was assessed. SDS scores for all 12 symptoms within the 3 dimensions were significantly associated with MED on Day 1 (F-value=1.56; P=0.04), as well as cumulative MED used on Days 0 and 1 (F-value=1.85; P<0.01). Patients with a specific CME used a higher MED than those without a CME on Day 1 (P<0.001). Between Days 1 and 4, patients with a higher number of patient-CME-days used a significantly higher MED. Regression analyses suggested that once the MED reached a threshold, approximately every 4 mg increase in MED was related to 1 additional patient-CME-day (P<0.01). A dose-response relationship empirically exists between MED and directly assessed opioid-related CMEs after ambulatory laparoscopic cholecystectomy. Once daily MED reaches a threshold, every 3-4 mg increase will be associated with 1 additional clinically meaningful opioid-related symptom, or 1 additional patient-day with an opioid-related CME.
PMID: 15223083 [PubMed - indexed for MEDLINE]
Comment on:
Intensive versus moderate lipid lowering with statins after acute coronary syndromes.
Auer J, Weber T, Eber B.
Publication Types:
PMID: 15309747 [PubMed - indexed for MEDLINE]
Comment on:
Intensive versus moderate lipid lowering with statins after acute coronary syndromes.
Miller M.
Publication Types:
PMID: 15309746 [PubMed - indexed for MEDLINE]
Comment on:
Intensive versus moderate lipid lowering with statins after acute coronary syndromes.
Gotto AM Jr.
Publication Types:
PMID: 15309745 [PubMed - indexed for MEDLINE]
Comment on:
Intensive versus moderate lipid lowering with statins after acute coronary syndromes.
Paradis JM, LeLorier J.
Publication Types:
PMID: 15309744 [PubMed - indexed for MEDLINE]
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