Medwave
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Inhalation therapy has proven to be the best way to control the asthma and chronic obstructive pulmonary disease symptoms. The most commonly used delivery system to control these symptoms is the metered-dose inhaler. The primary goal of this study is to demonstrate an association between incorrect inhaler use and patient age. ⋯ The percentage of incorrect inhaler use, in the general population is high. Even if we found no association between an incorrect technique and the person who taught it; still, there is a high percentage of errors and it was even demonstrated that being instructed by a pulmonologist does not guarantee a correct performance of metered-dose inhaler inhalations.
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Meta Analysis
Should we add vancomycin antibiotic powder to prevent post operative infection in spine surgery?
Intravenous antibiotic prophylaxis is routinely administered to prevent surgical site infection in spinal surgery. Adding intrawound vancomycin powder before surgical closure might further decrease infection risk. ⋯ We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded vancomycin probably does not decrease the risk of infection in low risk surgery, but there is uncertainty about its effects in populations or surgeries with a higher risk because the certainty of the evidence is very low.
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Comparative Study
[Retrospective study comparing low-dose versus standard dose of bortezomib in patients with multiple myeloma].
Bortezomib is a selective inhibitor of the proteosoma that is used in multiple myeloma. In combination with other antineoplastic drugs, it has a well-documented impact in progression-free survival rates and overall survival rates with standard doses (1.3-1.5 mg/m(2)). However, up to 88% of patients on standard doses have unwanted side effects (neutropenia, neuropathy or anemia. Standard dose (1.3 mg/m(2)) is used in almost all patients and low dose (0.7-0.8 mg/m(2)) is reserved for patients with kidney disease and neuropathy. ⋯ This retrospective analysis suggests that lower doses of bortezomib have similar effects in disease control measured by flow cytometry and cytology compared to standard doses in multiple myeloma patients.
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Patients with systemic sclerosis frequently have Raynaud's phenomenon and digital ischemic ulcers. Iloprost, a synthetic prostacyclin analogue, may be effective in these cases. ⋯ We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded iloprost may lead to little or no difference in the frequency or severity of secondary Raynaud, and it is associated to adverse effects and important costs.
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Review Case Reports
[Stercoral perforation of the colon: case report and literature review].
Colon perforation has several causes, including stercoral perforation of the colon, which was first described in 1894. Currently, reported cases are fewer than 100. ⋯ Stercoral perforation of the colon is a rare cause of bowel perforation, which should be suspected in patients with a history of chronic constipation, acute abdominal pain, bloating and sepsis, in order to intervene in a timely fashion.