- Esmolol does not improve quality of postsurgical recovery after ambulatory hysteroscopy: A prospective, randomized, double-blinded, placebo-controlled, clinical trial. [Journal Article]
- MMedicine (Baltimore) 2018; 97(41):e12647
- CONCLUSIONS: Despite current evidence in the literature that intraoperative esmolol improves postsurgical pain, we did not detect a beneficial effect of intraoperative esmolol on patient-reported quality of recovery after ambulatory surgery. Our results confirm the concept that the use of patient-centered outcomes rather than commonly used outcomes (e.g., pain scores and opioid consumption) can change the practice of perioperative medicine.
- Effect of Classic Foot Massage on Vital Signs, Pain, and Nausea/Vomiting Symptoms After Laparoscopic Cholecystectomy. [Journal Article]
- SLSurg Laparosc Endosc Percutan Tech 2018 Oct 11
- This semiexperimental study on the effects of foot massage recruited 88 patients who underwent laparoscopic cholecystectomy at the general surgery clinics of our hospital in Turkey (June 2017 to May ...
This semiexperimental study on the effects of foot massage recruited 88 patients who underwent laparoscopic cholecystectomy at the general surgery clinics of our hospital in Turkey (June 2017 to May 2018). Patients were assigned to either the intervention group (n=44, 10 min of classic foot massage) or the control group (n=44, no intervention). Pretest assessment, intervention, and posttest assessment were conducted within 1 to 6 hours postoperatively. Outcome measures included vital signs, pain, and nausea/vomiting symptoms. The intervention was associated with a significant decrease in pain scores and incidence of nausea. Despite being associated with an increase in body temperature, the intervention was also associated with a decrease in systolic blood pressure without increasing diastolic blood pressure or respiratory rate, suggesting a positive effect on blood circulation. Classic foot massage may serve as an affordable and useful way to help improve pain, nausea, and blood circulation after laparoscopic cholecystectomy.
- A Case series of candy cane limb syndrome after laparoscopic Roux-en-Y gastric bypass. [Journal Article]
- JSJ Surg Case Rep 2018; 2018(10):rjy244
- Candy cane syndrome is a rare complication reported in bariatric patients following Roux-en-Y gastric bypass. It occurs when there is an excessive length of roux limb proximal to gastrojejunostomy, c...
Candy cane syndrome is a rare complication reported in bariatric patients following Roux-en-Y gastric bypass. It occurs when there is an excessive length of roux limb proximal to gastrojejunostomy, creating the possibility for food particles to lodge and remain in the blind redundant limb. Patients present with non-specific symptoms such as abdominal pain associated with nausea and vomiting. Most remain undiagnosed as the disease process is poorly described. We report three cases of candy cane syndrome treated successfully at our institution.
- Weekly versus triweekly cisplatin plus intensity-modulated radiotherapy in locally advanced nasopharyngeal carcinoma: A propensity score analysis with a large cohort. [Journal Article]
- JCJ Cancer 2018; 9(19):3447-3455
- Purpose: To directly compare the efficacy and acute toxicities of intensity-modulated radiotherapy (IMRT) concurrent with weekly cisplatin (40 mg/m2) to high-dose concurrent cisplatin (100 mg/m2) at ...
Purpose: To directly compare the efficacy and acute toxicities of intensity-modulated radiotherapy (IMRT) concurrent with weekly cisplatin (40 mg/m2) to high-dose concurrent cisplatin (100 mg/m2) at three-week intervals. Materials and Methods: A total of 3,799 patients diagnosed with locally advanced nasopharyngeal carcinoma (NPC) at Sun Yat-Sen University Cancer Center between January 2010 and December 2013 were retrospectively reviewed. Propensity score analysis was conducted to balance the baseline characteristics between the groups, which allowed us to draw reliable conclusions. The efficacy and safety profiles were then assessed in the well-balanced large cohort. Results: The risk of distant metastasis was lower among the patients treated with weekly concurrent cisplatin than among those treated with the triweekly regimen (hazard ratio [HR], 0.45; P = .028). However, the disease-free survival, loco-regional relapse-free survival and overall survival rates were similar. The weekly group showed significantly higher rates of grade 3-4 thrombocytopenia, but lower rates of grade 3-4 mucositis, nausea and vomiting than the triweekly group. Conclusion: IMRT concurrent with a weekly cisplatin regimen was associated with significantly improved distant metastasis-free survival in locally advanced NPC. Differences in the selected acute toxicities between the weekly and triweekly concurrent cisplatin regimens were noted.
- Diabetic gastroparesis: current challenges and future prospects. [Review]
- CEClin Exp Gastroenterol 2018; 11:347-363
- Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain ...
Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States. However, a black box warning in 2009 reporting its association with tardive dyskinesia and recommending caution in chronically using this agent beyond 3 months has decreased its role in clinical practice. There is an unmet need for new prokinetics with good efficacy and safety profiles. Currently, there are several new drugs with different mechanisms of action in the pipeline that are under investigation and show promising preliminary results. Surgically combining gastric electrical stimulation with pyloroplasty is considered "gold" standard. Advances in therapeutic endoscopic intervention with gastric per-oral endoscopic pyloromyotomy have also been shown to improve gastric emptying and gastroparesis (GP) symptoms. In this review, we will comment on the challenges encountered when managing patients with DMGP and provide an update on advances in drug development and endoscopic and surgical interventions.
- Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School. [Journal Article]
- WEWilderness Environ Med 2018 Oct 08
- CONCLUSIONS: Results from the NWOBS database are consistent with those from other expeditionary OE programs. These findings should guide risk-management strategies and staff medical training.
- [Curative Effect of Aprepitant Preventing CINV]. [Journal Article]
- ZFZhongguo Fei Ai Za Zhi 2018 Oct 20; 21(10):800-804
- CONCLUSIONS: Aprepitant with tropisetron and dexamethasone prevented effectively CNIV for patients receiving Cisplatin chemotherapy. This combination could improve the quality of life and the compliance of patient with chemotherapy.
- Clinical manifestations of hydropic ear disease (Menière's). [Journal Article]
- EAEur Arch Otorhinolaryngol 2018 Oct 10
- CONCLUSIONS: This study marks the beginning of the clinical characterization of hydropic ear disease. The findings have important implications for the future formulation of clinical diagnostic criteria.
- Recurrent Nausea and Vomiting in a Pregnant Woman with Chronic Marijuana Use. [Journal Article]
- CRCase Rep Obstet Gynecol 2018; 2018:9746062
- CONCLUSIONS: Abstinence from cannabis use is highly recommended in pregnant women due to its potential harm in fetal development and stimulation of intractable nausea and vomiting. Recognizing the symptoms and proper history taking prompt early diagnosis, allowing timely and adequate treatment.
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- Hepatic Involvement in Systemic Sarcoidosis. [Journal Article]
- AJAm J Case Rep 2018 Oct 11; 19:1212-1215
- CONCLUSIONS: The majority of patients with hepatic sarcoidosis are usually asymptomatic, with only 5-30% presenting with abdominal pain, jaundice, nausea, vomiting, and hepatosplenomegaly. In rare cases, hepatic sarcoidosis can lead to cholestasis, portal hypertension, cirrhosis, or Budd-Chiari syndrome. Treatment with steroids is the mainstay of therapy; however, in severe cases, patients may require liver transplantation. This case report demonstrates that hepatic sarcoidosis is a serious condition, and if not treated, can lead to portal hypertension and cirrhosis. In patients with sarcoidosis, early detection and longitudinal follow-up is important in preventing overt liver failure.