The Journal of international medical research
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The amount and quality of pharmacology and pharmacy research by authors from China was investigated by comparing published articles from 136 international journals (1998 - 2007) by authors from mainland China, Hong Kong and Taiwan. The number of articles, clinical trials, randomized controlled trials, case reports, impact factors, number of citations and number of articles published in top general medicine journals were compared. ⋯ In total, there were 12 021 articles: 7576 from mainland China, 3267 from Taiwan and 1178 from Hong Kong. The accumulated impact factor of the articles from mainland China (16 688.94) was much higher than for those from Taiwan (8726.92) and Hong Kong (3161.22) but, among the three regions, Hong Kong had the highest mean impact factor and the most articles published in top general medicine journals.
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Practice Guideline
Guidelines for the pharmacological treatment of peripheral neuropathic pain: expert panel recommendations for the middle East region.
Neuropathic pain (NeP) has been the focus of extensive basic and clinical research over the past 20 years. This has led to an increased understanding of underlying pathophysiological mechanisms and the development of new therapeutic agents, as well as a clearer definition of the role of established medications. To date there are no published treatment guidelines for NeP in the Middle East. ⋯ The expert panel recommended pregabalin, gabapentin and secondary amine tricyclic antidepressants (nortriptyline and desipramine) as first-line treatments for peripheral NeP. Serotonin-norepinephrine reuptake inhibitor antidepressants, tramadol and controlled-release opioid analgesics were recommended as second-line treatments. There is a need to increase diagnostic awareness of NeP, use validated screening questionnaires and undertake more treatment research in the Middle East region.
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Randomized Controlled Trial
Neuromuscular blockade by vecuronium during induction with 5% sevoflurane or propofol.
This randomized trial investigated whether 5% sevoflurane potentiated neuromuscular blockade by vecuronium. General anaesthesia was induced with 5% sevoflurane in oxygen in 16 patients or with propofol in 16 patients. After loss of consciousness, vecuronium was administered to all participants at randomly assigned doses of 25, 30, 35 or 40 μg/kg. ⋯ In both groups, maximum blockade at the corrugator supercilii was significantly less intense than that achieved at the adductor pollicis. In the dose-response analysis, the 50% and 95% effective doses were lower for sevoflurane than for propofol in both muscles, although this did not reach statistical significance. It is concluded that induction of general anaesthesia with sevoflurane might provide improved conditions for intubation and reduce airway problems.
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Randomized Controlled Trial
Procalcitonin: a novel cardiac marker with prognostic value in acute coronary syndrome.
Procalcitonin (PCT) is implicated as an inflammatory marker in early atherosclerosis. In order to investigate the clinical consequences of increased PCT levels in acute coronary syndrome (ACS), 77 patients (29 with non-ST-elevation myocardial infarction [MI], 34 with ST-elevation MI and 14 with unstable angina pectoris) were included and followed up for 6 months. ⋯ The PCT levels within 48 h post-admission in the nine patients who died within 6 months were also significantly higher compared with the survivors (0.451 +/- 0.44 versus 0.406 +/- 1.37 ng/ml, respectively). It is concluded that higher PCT levels within 48 h post-admission may reflect an inflammatory state that is associated with increased early and 6-month mortality.
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Randomized Controlled Trial
Pre-measured length using landmarks on posteroanterior chest radiographs for placement of the tip of a central venous catheter in the superior vena cava.
Central venous catheterization (CVC) is a common procedure but catheter misplacement is a frequent complication and can be lethal. Most CVCs are inserted at a recommended mean depth of 15 cm from the skin puncture site. Chest radiographs are used to confirm the positioning of CVCs, with the carina regarded as a reliable landmark for tip placement. ⋯ To test the accuracy of C-length based CVC placement, 637 adult patients scheduled to undergo elective major abdominal procedures and neurological surgical procedures requiring CVC were randomized to undergo either the 15-cm guided method or the C-length guided method for placement of the CVC tip into the superior vena cava (SVC). All the CVC tips in the C-length group were successfully placed in the SVC. These findings indicate that the pre-measured C-length using two landmarks can be used to determine the insertion length and to place the CVC tip successfully into the SVC.