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[Early extubation with caudal morphine after pediatric heart surgery].

OBJECTIVES: To analyze the viability of immediate extubation of children after corrective surgery for congenital heart defects with extracorporeal membrane oxygenation using an anesthetic technique involving caudal morphine, and to study the effect on length of stay in the pediatric intensive care unit (PICU) or elsewhere in the hospital. MATERIAL AND METHODS: Twenty-nine ASA I-II patients without coagulation alterations undergoing surgery to correct simple heart defects were selected for extubation after surgery. Anesthesia was provided with with sevoflurane, midazolam, rocuronium, fentanil

Cromolyn sodium suppresses eosinophilic inflammation in patients with aspirin-intolerant asthma.

BACKGROUND: Although administration of cromolyn sodium is one of the most useful drugs for the treatment of aspirin-intolerant asthma (AIA), both its pharmacologic mechanism of action and association with the pathogenesis remain obscure. OBJECTIVE: This study was designed to investigate the protective effect of cromolyn sodium on airway responsiveness to the sulpyrine provocation test, and to examine whether its activity is associated with a reduction in eosinophilic inflammation. METHODS: Patients were randomly assigned to receive cromolyn sodium (20 mg/2 mL, or 1 ampoule; Fujisawa, Osaka,

Adverse drug reaction monitoring: support for pharmacovigilance at a tertiary care hospital in Northern Brazil.

BACKGROUND: Adverse drug reactions (ADRs) are recognised as a common cause of hospital admissions, and they constitute a significant economic burden for hospitals. Hospital-based ADR monitoring and reporting programmes aim to identify and quantify the risks associated with the use of drugs provided in a hospital setting. This information may be useful for identifying and minimising preventable ADRs and may enhance the ability of prescribers to manage ADRs more effectively. The main objectives of this study were to evaluate ADRs that occurred during inpatient stays at the Hospital Geral de Palm

[Estimation of postoperative pain after tonsillectomy in adults using QUIPS: an instrument to improve postoperative pain management].

BACKGROUND: Tonsillectomy leads to strong postoperative pain. Pain management often is not optimal after tonsillectomy. To date, there exists no clear guideline for pain management after tonsillectomy. METHODS: In a prospective study 65 tonsillectomy patients were examined at the first postoperative day within the QUIPS project. This allowed a standardised assessment of patients' characteristics, pain parameters, outcome and process parameters. The influence of these parameters on the patients' postoperative pain was estimated with univariate and multivariate statistic analysis. RESULTS: All

General practitioners' decision-making strategies in the pharmacological treatment of musculoskeletal pain: A qualitative interview study.

BACKGROUND: Musculoskeletal pain is a leading reason for primary care visits and often requires pharmacological treatment. Despite rising prescription rates for non-opioid analgesics in Germany, little is known about GPs' broader prescribing behaviour beyond opioid-related discussions. Understanding how GPs navigate pain management is key to supporting evidence-based prescribing. OBJECTIVES: This study explored GPs' decision-making strategies when prescribing for musculoskeletal pain and identified clinical challenges. METHODS: A qualitative study using semi-structured interviews was conduct

[Stress response under continuous infusion of remifentanil compared to bolus doses of fentanyl assessed by levels of cytokines, C-reactive protein, and cortisol during and after abdominal hysterectomy].

OBJECTIVES: Surgery and anesthetic method have immunomodulating effects on hemodynamic response and stress. We compared the effects of 2 intraoperative analgesic regimens on patients undergoing abdominal hysterectomy. MATERIAL AND METHODS: We conducted a randomized double-blind trial in ASA 1 and 2 patients undergoing abdominal hysterectomy under balanced anesthesia. Twenty-nine patients were randomized to 2 groups. One group received analgesia by infusion of remifentanil plus morphine and nonsteroidal anti-inflammatory drugs as rescue medications; the other received conventional analgesia wi

Comparing cold-air analgesia, systemically administered analgesia and scalp nerve blocks for pain management during photodynamic therapy for actinic keratosis of the scalp presenting as field cancerization: a randomized controlled trial.

BACKGROUND: Photodynamic therapy (PDT) using methyl aminolaevulinate (MAL) is an effective treatment for extensive actinic keratosis (AK). However, pain is a major side-effect of this therapy. OBJECTIVES: To investigate whether scalp nerve blocks (group 1) provide adequate pain relief during MAL-PDT of the scalp and forehead in 32 men with baldness. METHODS: The patients received intravenous (IV) analgesia [piritramide 7.5 mg IV, plus oral metamizole (40 drops 30 min prior to PDT)] in combination with cold-air analgesia (group 2; IV analgesia) and cold-air analgesia alone (group 3). Maximum

Chronic gastric ulcer healing in rats subjected to selective and non-selective cyclooxygenase-2 inhibitors.

UNLABELLED: The influence of different nonsteroidal anti-inflammatory drugs (NSAIDs) and of a proton pump inhibitor on the healing parameters of a chronic gastric ulcer was evaluated. Wistar rats were used after the induction of a chronic acetic acid ulcer. The animals were treated orally for 8 and 15 days, twice daily, with the conventional NSAID, piroxicam (0.35 mg/kg), the non-narcotic analgesic, metamizol (33 mg/kg), the selective cyclooxygenase-2 inhibitor, celecoxib (1.8 mg/kg) and the proton pump inhibitor, omeprazole (0.35 mg/kg). Macroscopic ulcer index, myeloperoxidase activity and p

Effect of adverse drug reactions on length of stay in surgical intensive care units.

OBJECTIVE: To determine the frequency of adverse drug reactions in surgical intensive care units and evaluate their effect on the length of stay. DESIGN: Prospective cohort study. Between May 1997 and December 1999, while the patients were staying in the surgical intensive care unit, data were gathered regarding suspected adverse drug reactions and on different variables related to the length of stay. SETTING: Surgical intensive care units of our hospital. PATIENTS: A total of 401 patients hospitalized in the surgical intensive care unit. MAIN RESULTS: In 37 of the 401 patients seen (9.2%;

Metamizole is a Moderate Cytochrome P450 Inducer Via the Constitutive Androstane Receptor and a Weak Inhibitor of CYP1A2.

Metamizole is an analgesic and antipyretic drug used intensively in certain countries. Previous studies have shown that metamizole induces cytochrome (CYP) 2B6 and possibly CYP3A4. So far, it is unknown whether metamizole induces additional CYPs and by which mechanism. Therefore, we assessed the activity of 6 different CYPs in 12 healthy male subjects before and after treatment with 3 g of metamizole per day for 1 week using a phenotyping cocktail approach. In addition, we investigated whether metamizole induces CYPs by an interaction with the constitutive androstane receptor (CAR) or the preg

Selective induction of human hepatic cytochromes P450 2B6 and 3A4 by metamizole.

The pyrazolone drug metamizole is a widely used analgesic. Analysis of liver microsomes from patients treated with metamizole revealed selectively higher expression of cytochromes P450, CYP2B6 and CYP3A4 (3.8- and 2.8-fold, respectively), and 2.9-fold higher bupropion hydroxylase activity compared with untreated subjects. Further investigation of metamizole and various derivatives on different potential target genes in human primary hepatocytes demonstrated time- and concentration-dependent induction by metamizole of CYP2B6 (7.8- and 3.1-fold for mRNA and protein, respectively, at 100 muM) and

Cutaneous drug reaction case reports: from the world literature.

Skin disorders are the most common adverse reactions attributed to drugs. Any skin disorder can be imitated, induced or aggravated by drugs. To help you keep up-to-date with the very latest skin reactions occurring with both new and established drugs, this section of the journal brings you information selected from the adverse drug reaction alerting service Reactions Weekly. The following case reports are selected from the very latest to be published in the world dermatology literature. Any claim of a first report has been verified by a search of AdisBase (a proprietary database of Adis Intern

Localized fungal osteomyelitis caused by Aspergillus sp. in the ilium and acetabulum of a dog with disseminated aspergillosis: A case report.

BACKGROUND: Osteomyelitis caused by Aspergillus sp. is uncommon in dogs and cats and may occur in cases of disseminated aspergillosis, a rare and poorly described condition in veterinary medicine. CASE DESCRIPTION: Due to the scarcity of reports documenting this disease, particularly with localized involvement of the pelvic bones, the present case report aimed to describe the condition in an 8-year-old mixed-breed dog presenting with severe pain and lameness of the right pelvic limb. Radiographic examination revealed marked periosteal bone proliferation and osteolysis extending from the right

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… Postoperative medications included dipyrone (25 mg/kg PO q12 hours for 7 days), tramadol hydrochloride (5 mg/kg PO q12 hours for 7 days), meloxicam (0.1 mg/kg PO q24 hours for 5 days), and cephalexin (30 mg/kg PO q12 hours for 10 days). …

Virtual reality and hypnosis for symptom alleviation before bone marrow procedure.

Bone marrow aspiration biopsy (BMAB) commonly causes anxiety in patients, negatively affecting their overall procedural experience. We aimed to evaluate the efficacy of hypnosis and virtual reality (VR) compared to standard-of-care in improving concerns of patients undergoing BMAB. In this exploratory open-label randomized-controlled trial, adult patients undergoing BMAB were randomly assigned to hypnosis, VR, or control. Interventions included a 7-minute prerecorded hypnosis session or immersive VR experience immediately prior to the procedure. Patient concerns were measured using the Measure

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… In the 3 arms, patients received SOC management of BMAB including local anesthesia (intraosseous lidocaine 2%) for all patients; benzodiazepine sedation (intravenous midazolam) for patients that wished to be sedated during the procedure; and post-BMAB analgesics (generally paracetamol or dipyrone) for …

Diagnosis and management of neutropenia in adults: Expert guidance.

Neutropenia in general is defined as a blood neutrophil count of less than 1.5 × 109/L, in severe neutropenia counts drop to less than 0.5 × 109/L, but the definition of neutropenia varies according to the patient's ethnic origin and age. For Caucasian adults, the absolute neutrophil count (ANC) threshold of 1.8 × 109/L is adopted for the definition of neutropenia according to the World Health Organization (see Fioredda et al. (1)). It can be inherited or acquired, and it is an uncommon haematological finding in adult outpatient clinics. Neutropenia can result from decreased production of neut

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… beta‐lactams, cefipime, trimethoprim‐sulfametoxazole, sulfasalazine, vancomycin, rifampicin, fluconazole, ketoconazole), anti‐diuretics (furosemide, spironolactone), antiretroviral human immunodeficiency virus (HIV) therapy, anti‐thyroids (tiamazofe, metimazole), clozapine (olanzapine), deferiprone, dipyrone …

Pathological Mechanisms of Bortezomib-Induced Peripheral Neuropathy.

Bortezomib, a first-generation proteasome inhibitor widely used in chemotherapy for hematologic malignancy, has effective anti-cancer activity but often causes severe peripheral neuropathy. Although bortezomib-induced peripheral neuropathy (BIPN) is a dose-limiting toxicity, there are no recommended therapeutics for its prevention or treatment. One of the most critical problems is a lack of knowledge about pathological mechanisms of BIPN. Here, we summarize the known mechanisms of BIPN based on preclinical evidence, including morphological abnormalities, involvement of non-neuronal cells, oxid

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… The TRPA1 channel mediates the analgesic action of dipyrone and pyrazolone derivatives. Br. J. Pharmacol. 2015;172:3397–3411. doi: 10.1111/bph.13129. 44. Tonello R., Fusi C., Materazzi S., Marone I.M., De Logu F., Benemei S., Goncalves M.C., Coppi E., Castro-Junior C.J., Gomez M.V., et al. …

Effect of Bacterial Nanocellulose with Chemisorbed Antiseptics on Alveolar Bone Repair in Rats Undergoing Bisphosphonate Therapy.

Objectives: This work investigated the effect of bacterial nanocellulose (BNC) alone or with chemisorbed chlorhexidine or povidone-iodine on post-tooth extraction repair in rats undergoing bisphosphonate therapy. Methods: Forty Wistar rats were treated with zoledronic acid, subjected to tooth extractions and allocated into groups according to the material inserted in the post-extraction socket: (1) BNC (n = 10); (2) BNC/Iodine (n = 10); (3) BNC/Chlorhex (n = 10); (4) Control (n = 10). Maxillae were dissected and macro- and microscopically analyzed. Results: Oral lesion frequency on macroscopic

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… For postoperative analgesia, dipyrone (200 mg/kg) was administered subcutaneously. After tooth extractions, the animals were kept on zoledronic acid treatment. 2.4. …

Mitigating jaw osteonecrosis: bioactive glass and pericardial membrane combination in a rat model.

OBJECTIVES: Bisphosphonates (BFs) show clinical effectiveness in managing osteoporosis and bone metastases but pose risks of bisphosphonate-related jaw osteonecrosis (BRONJ). With no established gold standard for BRONJ treatment, our focus is on symptom severity reduction. We aimed to assess the preventive effects of bioactive glass and/or pericardial membrane in a preclinical BRONJ model, evaluating their potential to prevent osteonecrosis and bone loss post-tooth extractions in zoledronic acid (ZA)-treated animals. METHODS: Rats, receiving ZA or saline biweekly for four weeks, underwent 1st

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… After the extractions, the rats were given sodium dipyrone (100 mg/kg) every 12 hours under the skin for the first 72 hours to manage immediate pain. Additionally, their weekly water and food intake, along with their weight, were measured. …

Cancer in Pregnancy: Therapeutic Decisions at the Intersection of Two Lives.

Background: Cancer during pregnancy is a rare but increasingly encountered condition due to delayed childbearing and improved survival of women with cancer. The coexistence of malignancy and pregnancy poses complex diagnostic and therapeutic challenges, requiring careful balance between maternal prognosis and fetal safety. Objective: This review aims to summarize current evidence on the diagnosis and multidisciplinary management of cancer during pregnancy, focusing on the safe use of oncologic therapies, obstetric decision-making, and maternal and fetal outcomes. Methods: A narrative review wa

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… Commonly used analgesics, such as dipyrone and paracetamol, are considered safe during pregnancy, as is the short-term use of opioids, which is generally well tolerated by the fetus. In contrast, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) requires caution [ 4 , 47 ]. …

Bortezomib-induced peripheral neuropathy: from molecular mechanisms to clinical management.

Bortezomib (BTZ) is a first-generation proteasome inhibitor that has shown significant efficacy in the treatment of multiple myeloma (MM), providing significant therapeutic benefits without severely compromising overall patient health. However, one of the most common and debilitating side effects associated with BTZ therapy is bortezomib-induced peripheral neuropathy (BIPN). This condition is the leading complication observed in patients undergoing BTZ treatment and has a profound impact on treatment regimens, often necessitating dose reductions or alterations in the dosing schedule. Despite t