Current medical research and opinion
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Stress urinary incontinence is the most prevalent form of urinary incontinence. In spite of its significant negative impact on quality of life less than one-third of patients in the UK present with symptoms to their GP. The current mainstay treatment is pelvic floor exercises. ⋯ This article profiles current treatments and the place of an oral agent in stress urinary incontinence. This review article includes papers that were retrieved through PubMed using search criteria 'stress urinary incontinence', 'management' and the specific therapy area, e.g. tension-free vaginal tape. The main guidance of the Department of Health (London, UK) and associated bodies was also used.
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Extreme and severe cases of constipation can lead to faecal impaction. Current therapies are often both ineffective and unpleasant. The objective of this trial was to evaluate the efficacy and safety of Movicol, a polyethylene glycol (PEG) + electrolyte solution (PEG+E), as treatment for severe constipation and faecal impaction. ⋯ PEG+E, administered orally at a dose equivalent to eight 13.8 g sachets (1 L) per day over three days, was a highly effective and well tolerated therapy for the treatment of severe constipation and faecal impaction.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between IV paracetamol and IV metamizol for postoperative analgesia after retinal surgery.
To assess clinical efficacy of IV paracetamol 1 g and IV metamizol 1 IV metamizol 1 g on a 24-h dosing schedule in this randomized, double-blinded, placebo-controlled study of 38 ASA physical status I-III patients undergoing retinal surgery. ⋯ IV paracetamol 1 g has a similar analgesic potency as IV metamizol 1 g for postoperative analgesia after retinal surgery.
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Review
Impact of long-term use of opioids on quality of life in patients with chronic, non-malignant pain.
The use of opioids in the management of non-malignant pain remains controversial. For many physicians, pain relief stemming from opioid use is not enough unless there is also a noticeable change in quality of life (QoL) and patient functioning. The impact of long-term opioid treatment on patients' QoL has been investigated in a limited number of trials, and these studies differ considerably with respect to their design and principal findings. This systematic review presents the results of these studies. ⋯ There is both moderate/high- and low-quality evidence suggesting that long-term treatment with opioids can lead to significant improvements in functional outcomes, including QoL, in patients with chronic, non-malignant pain. However, further methodologically rigorous investigations are required to confirm the long-term QoL benefit of opioid treatment in these patients, and to elucidate the effect of physical tolerance, withdrawal and addiction, which are all associated with long-term use of opioids, on patients' functional status.
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To evaluate differential compliance rates between immediate-release (IR) selective serotonin reuptake inhibitors (SSRI) and a controlled-release (CR) SSRI in patients initiating SSRI therapy. ⋯ Approximately 54% of patients initiating SSRI therapy were noncompliant with SSRI therapy over a 6-month period, with the lowest level of compliance found in patients receiving IR SSRI agents. Future studies should assess the effect of compliance on economic measures and determine if reductions in resource utilization are found across specific SSRI agents.