Proceedings of the Western Pharmacology Society
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Proc. West. Pharmacol. Soc. · Jan 2010
Randomized Controlled Trial Comparative StudyEffectiveness of diclofenac, ketorolac and etoricoxib in the treatment of acute pain from ankle fracture.
Tissue degeneration, infection, inflammation, cancer, trauma, surgery and limb fractures all produce pain. Each of these physiological abnormalities requires a therapeutic approach different from the last. In acute pain, caused by fracture, several classes of analgesics have been utilized. ⋯ All treatments showed a similar profile in pain reduction. Etoricoxib, diclofenac and ketorolac twice daily are a rapid and effective treatment for acute pain. All the regimens were well tolerated in this study.
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Proc. West. Pharmacol. Soc. · Jan 2010
Randomized Controlled Trial Comparative StudyPercutaneous microdiscectomy versus epidural injection for management of chronic spinal pain.
In this study we present the efficacy of aspiration of disc material employing the Stryker Disc Dekompressor during percutaneous microdiscectomy for the treatment of chronic spinal and radicular pain due to contained lumber disc herniation and compare the short-term outcome in such patients with those who received lumber epidural injection. A total of 50 patients with chronic lumber discogenic pain and radiculopathy were enrolled in this study and were randomized into two groups. Group 1 (n=26) underwent first time, single-level lumber discectomy at either L3-4, L4-5, or L5-S1 using the Stryker Disc Dekompressor for aspiration of disc material and Group 2 (n=24) received epidural steroid/local anesthetic injection. ⋯ We conclud that when standardized patient selection criteria are used, the disc DeKompressor is a safe and more effective treatment for radicular pain of discogenic origin than epidural injection with steroid/local anesthetic. Back pain of discogenic origin was more effectively treated with the epidural steroid/local anesthetic injection. Treatment of patients with radicular pain associated with contained disc herniation using the Dekompressor can be a safe and more effective procedure.
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Proc. West. Pharmacol. Soc. · Jan 2009
Randomized Controlled TrialEfficacy of postoperative continuous wound infiltration with local anesthetic after major abdominal surgery.
The aim of this study was to evaluate the analgesic efficacy, safety, opioid sparing effects and improvement of respiratory function when using 0.2% ropivacaine continuous wound infiltration after major intra-abdominal surgery. Forty patients undergoing major intra-abdominal surgery requiring a midline incision of > or = 20 cm were enrolled into this IRB-approved, randomized, prospective controlled study. Group 1: 20 patients, parenteral analgesia (control group). ⋯ The patient vital capacities were insignificantly higher in group II. We conclude that after major abdominal surgery, infiltration and continuous wound instillation with 0.2% ropivacaine decreases postoperative pain, opioid requirements and oral analgesia. Early patient rehabilitation, hastening convalescence, and preventing respiratory complications are expected outcomes of this approach.
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Proc. West. Pharmacol. Soc. · Jan 2009
A review of patient safety in women's healthcare: why has our progress been so slow?
The rate of improvement in patient safety is slow. The goal of this review is to address the results of a survey of Ob-Gyn physicians regarding important patient safety issues. A sample of 600 obstetricians and gynecologists were sent a survey asking them about their beliefs, activities, problems, and source of information regarding patient safety with a response rate of 53.2%. ⋯ Ob-Gyns prefer to learn new patient safety information using printed materials and post graduate classes rather than materials on compact disk or online webcasts. A majority of respondents recognize patient safety as an important issue. Education about the importance of patient safety may be a less pertinent topic when compared to the need for education about implementing specific tools for patient safety and moving from awareness to action.
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Proc. West. Pharmacol. Soc. · Jan 2009
Platelet aggregation in whole blood, a new approach for understanding the antiplatelet effect of N-(3-hydroxy-1,3,5(10)-estratrien-17b-yl) butylamine (buame).
We have previously reported the effect of a compound derived from estradiol containing a radical amino butyl at the 17-beta position which has shown anticoagulant effects in whole blood and antiplatelet effects in light transmission aggregometry where platelets are isolated from other blood cells. In contrast, whole blood aggregometry includes the platelet interactions with blood elements such as erythrocytes and leukocytes. We examined the cooperative effect between leukocytes, erythrocytes and platelets and the antiplatelet effect of Buame in whole blood aggregometry, a tool to assess platelet function in its physiological environment. ⋯ This concentration-dependent pattern was shown in both whole blood and platelet aggregometry assays. When tested in light transmission aggregometry, a higher concentration of Buame was required in order to inhibit to the same degree ADP- or collagen-induced platelet aggregation (30 microM ,114 microM) than that required in the whole blood assay (IC50 84 microM, 191 microM). Interactions among different cell types in whole blood may modify the response of Buame-treated platelets to agonists suggesting a cooperative mechanism.