Postgraduate medicine
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Postgraduate medicine · Jan 2017
ReviewEconomic and clinical burden of opioid-induced nausea and vomiting.
Opioids are the standard of care for treating moderate-to-severe pain; however, their efficacy can be limited by adverse events (AEs), including nausea and vomiting. Opioid-induced nausea and vomiting (OINV) is an inherent adverse effect of opioid treatment, exerting effects centrally and peripherally. ⋯ Multiple factors may contribute to OINV, including activation of opioid receptors in the chemoreceptor trigger zone, vestibular apparatus, and gastrointestinal tract. Prophylactic or early treatment with antiemetics may be appropriate for patients who are at high risk for OINV.
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Postgraduate medicine · Jan 2017
Multicenter Study Comparative StudyA novel electromechanical autoinjector, AutoTouch™, for self-injection of etanercept: real-world use and benefits.
We assessed the ability of patients with autoimmune inflammatory diseases to successfully use the investigational AutoTouch™ reusable autoinjector as well as patient preference for AutoTouch™ versus the currently marketed single-use prefilled etanercept SureClick® autoinjector. ⋯ The introduction of the AutoTouch™ will give patients a choice between two different autoinjectors for self-administration of etanercept.
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Postgraduate medicine · Jan 2017
Review Meta Analysis Comparative StudyIncreased plasma/serum levels of prolactin in systemic lupus erythematosus: a systematic review and meta-analysis.
Prolactin (PRL), a polypeptide hormone produced by the pituitary gland, is involved in the regulation of humoral and cell mediated immune responses. PRL levels have been investigated in several autoimmune diseases including systemic lupus erythematosus (SLE), however, yielded different and inconsistent results. This study aims to derive a more precise evaluation on plasma/serum PRL levels in SLE patients, as well as the potential influential factors. ⋯ Overall, our study suggests that SLE patients have higher plasma/serum PRL level, but with a regional difference.
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Postgraduate medicine · Jan 2017
Multicenter Study Comparative Study Clinical TrialPrescription opioid abuse and misuse: gap between primary-care investigator assessment and actual extent of these behaviors among patients with chronic pain.
To compare the results of two open-label primary care-based studies that examined investigator assessment of patient risk for prescription opioid misuse, abuse, and diversion relative to patient self-reports and urine drug tests (UDTs). ⋯ www.clinicaltrials.gov identifiers: NCT00640042 and NCT01179191.
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Sarcoidosis is a multisystem disease characterized by the presence of noncaseating granulomas, the exact etiology of which is yet to be determined. Pulmonary involvement occurs in the majority of patients and its severity ranges from asymptomatic involvement of mediastinal lymph nodes to progressive pulmonary fibrosis and chronic respiratory failure that is insensitive to treatment. Diagnosis of pulmonary sarcoidosis requires a compatible clinical picture supported by radiologic and pathologic data. ⋯ A combined imaging modality using both FDG-PET and CT scan is more sensitive than PET alone and is now the standard of care in patients requiring biopsies of active lesions. Biologic agents like anti-tumor necrosis factor antibodies are being used as second line treatment in those patients dependent on steroids or in cases of refractory sarcoidosis. Lung transplantation is the final option in suitable patients with end-stage pulmonary sarcoidosis.