Current medical research and opinion
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Comparative Study Clinical Trial
Utilization of duloxetine and celecoxib in osteoarthritis patients.
To describe utilization patterns of duloxetine and celecoxib and subsequent opioid use among patients with osteoarthritis. ⋯ Osteoarthritis patients initiating duloxetine had better compliance and a lower likelihood of opioid utilization than those initiating celecoxib. Study limitations included lack of information on reasons for medication initiation and discontinuation, severity of disease symptoms, and use of over-the-counter medications.
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Review Meta Analysis
Do prokinetics influence the completion rate in small-bowel capsule endoscopy? A systematic review and meta-analysis.
The use of purging for bowel cleansing prior to small-bowel capsule endoscopy (SBCE) has now been established in clinical practice. Despite that, the number of incomplete SBCEs is still around 15-20%. To date, the use of prokinetics in SBCE - aiming to improve completion rate (CR) - remains a contentious issue resulting in lack of consensus among capsule experts. ⋯ Our pooled data shows that the use of prokinetics for capsule ingestion improves CR in SBCE. This effect appears to be particularly evident with metoclopramide, when used concurrently with purging and/or use of real-time monitoring. In a small number of studies, erythromycin showed - through its gastrokinetic effect - marginal benefit. No prokinetic has a beneficial effect on SBCE DY.
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Chronic pain is currently under-diagnosed and under-treated, partly because doctors' training in pain management is often inadequate. This situation looks certain to become worse with the rapidly increasing elderly population unless there is a wider adoption of best pain management practice. This paper reviews current knowledge of the development of chronic pain and the multidisciplinary team approach to pain therapy. ⋯ The patient also receives continuity of care, while pain relief is accompanied by improvements in physical functioning, quality of life and emotional stress. Other benefits include decreases in catastrophizing, self-reported patient disability, and depression. Improved training in pain management is clearly needed, starting with the undergraduate medical curriculum, and this review is intended to encourage further study by those who manage patients with chronic pain.
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Comparative Study Clinical Trial
Comparison of postoperative nausea between benign and malignant brain tumor patients undergoing awake craniotomy: a retrospective analysis.
Benign and malignant brain tumors have different histopathological characteristics, including different degrees of tissue infiltration and inflammatory response. The aim of this retrospective study was to compare the incidence of postoperative nausea between the two categories of brain tumors in patients undergoing awake craniotomy. ⋯ The different histopathological characteristics of brain tumors have no association with postoperative nausea in patients undergoing awake craniotomy. Patients with benign brain tumors experience more pain than patients with malignant brain tumors. This difference in postoperative pain may be due to the younger age of the patients in the benign group.
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Comparative Study
Real-world comparative outcomes of US type 2 diabetes patients initiating analog basal insulin therapy.
To evaluate outcomes in insulin-naive patients with type 2 diabetes mellitus (T2DM) who initiated insulin glargine or insulin detemir. ⋯ Results from this real-world EMR analysis suggest that among T2DM patients, initiating insulin treatment with insulin glargine may be associated with better treatment persistence and glycemic control, with similar prevalence of hypoglycemia and weight change, compared with initiating with insulin detemir. This study is limited by the retrospective nature of the data collection using EMRs and inability to confirm accuracy and completeness of data by secondary chart review.