Effects of pregabalin on postoperative pain after hysterectomy under spinal anesthesia with intrathecal morphine: a randomized controlled trial

Abstract

Purpose

To determine if preoperative pregabalin could decrease 24-h postoperative morphine consumption after spinal anesthesia with intrathecal morphine compared with placebo.

Methods

A randomized, double-blind, controlled trial was performed in the tertiary care center. Patients aged between 18 and 65 years who were American Society of Anesthesiologists class I–II and scheduled for abdominal hysterectomy with or without salpingo-oophorectomy were randomly allocated to a placebo or a pregabalin group. Patients received pregabalin 150 mg or placebo 1 h prior to anesthesia. Spinal anesthesia was achieved with 0.5% hyperbaric bupivacaine with morphine 0.2 mg. Intravenous patient-controlled analgesia morphine was provided postoperatively. Postoperative morphine consumption at 6, 12, and 24 h, time to first analgesic rescue, pain scores, adverse effects, and patient satisfaction were evaluated at 24 h after the operation.

Results

One hundred twenty-five patients were recruited and 119 patients (placebo N = 58, pregabalin N = 61) were included in the analysis. Forty-seven (81.0%) patients in the placebo group and 53 (86.9%) patients in the pregabalin group required morphine in the first 24 h. Median [IQR] 24-h morphine consumption was 4.0 [1.8, 10.0] mg in the placebo group and 5.0 [2.0, 11.0] mg in the prebagalin group, p = 0.60. There were no differences in cumulative morphine consumption at 6, 12, and 24 h postoperatively. The two groups also did not differ in time to first analgesic rescue, pain scores at rest and on movement, and side effects.

Conclusion

A single preoperative dose of pregabalin 150 mg did not reduce 24-h postoperative morphine consumption or pain scores or prolong the time to first analgesic rescue in spinal anesthesia with intrathecal morphine.

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Erratum to “The “Crumple Zone” hypothesis: Association of frontal sinus volume and cerebral injury after craniofacial trauma” [J Craniomaxillofac Surg 45 (2017) 1094–1098]

The publisher regrets that Michael P. Grant's surname appeared incorrectly in the original article. It appears correctly above.

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Tumor regression grading of gastrointestinal cancers after neoadjuvant therapy

Abstract

Neoadjuvant therapy has been successfully introduced in the treatment of locally advanced gastrointestinal malignancies, particularly esophageal, gastric, and rectal cancers. The effects of preoperative chemo- or radiochemotherapy can be determined by histopathological investigation of the resection specimen following this treatment. Frequent histological findings after neoadjuvant therapy include various amounts of residual tumor, inflammation, resorptive changes with infiltrates of foamy histiocytes, foreign body reactions, and scarry fibrosis. Several tumor regression grading (TRG) systems, which aim to categorize the amount of regressive changes after cytotoxic treatment in primary tumor sites, have been proposed for gastroesophageal and rectal carcinomas. These systems primarily refer to the amount of therapy-induced fibrosis in relation to the residual tumor (e.g., the Mandard, Dworak, or AJCC systems) or the estimated percentage of residual tumor in relation to the previous tumor site (e.g., the Becker, Rödel, or Rectal Cancer Regression Grading systems). TRGs provide valuable prognostic information, as in most cases, complete or subtotal tumor regression after neoadjuvant treatment is associated with better patient outcomes. This review describes the typical histopathological findings after neoadjuvant treatment, discusses the most commonly used TRG systems for gastroesophageal and rectal carcinomas, addresses the limitations and critical issues of tumor regression grading in these tumors, and describes the clinical impact of TRG.

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Growing evidence of the beneficial effects of a marine protein-based dietary supplement for treating hair loss

Summary

Background

Hair loss is a common condition among women with a range of causes including nutritional deficiencies.

Aims

To review the clinical data supporting the use of an oral marine supplement designed to promote hair growth.

Patients/Methods

Adult women with temporary thinning hair. Following an initial pilot study, five randomized, double-blind studies assessed the effectiveness of the oral marine supplement for promoting hair growth. Each study was approved by one or more institutional review boards.

Results

Together, these studies demonstrated the ability of oral marine supplements to increase the growth of terminal and vellus hairs, increase the diameter of terminal and vellus hairs, and decrease hair loss. This product is beneficial for men as well as women.

Conclusions

A dietary supplement containing a marine complex and other natural ingredients can safely and effectively promote hair growth and decrease hair shedding in women and men with thinning hair.

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Unusually prolonged pemetrexed cytotoxicity in a patient with a lung adenocarcinoma: a case report

We describe a case of pemetrexed toxicities related to reabsorption by an ileal neobladder, which caused prolonged hematotoxicity and nephrotoxicity.

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Biomarker levels in gingival crevicular fluid of generalized aggressive periodontitis patients after non-surgical periodontal treatment

Abstract

Objectives

The aim of this study was to assess the effects of non-surgical periodontal treatment on gingival crevicular fluid (GCF) cytokines in patients with generalized aggressive periodontitis (GAgP), in relation to clinical parameters.

Materials and methods

Data were obtained from 16 GAgP patients and 15 periodontally healthy controls. Periodontal parameters and GCF biomarker levels were evaluated at baseline and repeated 3 and 6 months after treatment for GAgP subjects. Moderate and deep pocket sites were analyzed separately. The amount of interleukin (IL)-1β, IL-9, tumor necrosis factor (TNF)-α, platelet-derived growth factor (PDGF-bb), and vascular endothelial growth factor (VEGF) were measured using a highly specific and sensitive multiplex bead immunoassay.

Results

At baseline, cytokine levels in the moderate and deep pocket sites of GAgP patients were higher than those of the healthy control sites. In GAgP group, periodontal treatment led to improvement in all examined clinical parameters and resulted in a statistically significant reduction in the total amounts of IL-1β, VEGF, and TNF-α, in comparison to baseline, already 3 months after therapy in both moderate and deep pocket sites and of PDGF-bb in deep sites (p < 0.01). At the concentration level, only IL-1β and VEGF were affected.

Conclusion

Non-surgical treatment of GAgP provided significant clinical benefits leading to a marked decrease in the GCF levels of some pro-inflammatory and pro-angiogenic cytokines, but not of IL-9 and PDGF-bb.

Clinical relevance

Although the periodontal therapy successfully decreased clinical signs of inflammation, the GCF levels of some inflammatory cytokines were still elevated.

http://ift.tt/2x3Znho

Does a mandibular access osteotomy improve survival in pT2 oral tongue cancers? Retrospective study at a single institution

The surgical approach to the resection of oral tongue cancers can involve transoral resection (TOR) or a temporary mandibulotomy access (TMA). There are no relevant guidelines, and the oncological safety of TOR needs consideration. The objective of this study was to investigate TMA and TOR in pT2 oral tongue cancer surgery with regard to cancer outcomes. Demographic, surgical, and histology data from primary pT2 tongue cancers were recorded and evaluated through multivariate Cox regression for local recurrence (LR), disease-free survival (DFS), and overall survival (OS).

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