Multiple Low Doses of Intravenous Corticosteroids to Improve Early Rehabilitation in Total Knee Arthroplasty: A Randomized Clinical Trial

J Knee Surg DOI: 10.1055/s-0038-1636506Low doses of corticosteroids have been proved to be effective in decreasing the inflammatory cytokines and relieving the pain. However, the optimal dosage of corticosteroids in total knee arthroplasty (TKA) is undetermined. A total of 103 patients were randomly divided into three groups. Group A containing 32 patients received normal saline. Group B including 36 patients used two doses of 100 mg hydrocortisone, given 2 hours before and 8 hours after surgery. Group C involving 35 patients received four doses of 100 mg hydrocortisone, 8 hours apart.The level of interleukin 6 (IL-6) and C-reactive protein (CRP) were lower in group C than those in group A when detected at 12, 24, and 48 hours after operation and even lower than that in group B at 24 and 48 hours (p  0.05), but it did not show statistic difference 24 hours later (p > 0.05). For comparison, patients with multiple doses achieved continuously better outcomes on pain management than the blank control group within postoperative 36 hours at rest and at 24 hours with activity. In addition, patients using multiple doses of hydrocortisone achieved fewer occurrences of nausea and vomiting, fever, and sleeplessness, better knee function recovery, better patient satisfaction, and shorter length of hospital stays (p 
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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CONCLUSION: Ulcerative colitis presented a high frequency of intestinal symptoms, and Crohn ’ s disease showed a high frequency of systemic manifestations at the onset of manifestation. There was a long delay in diagnosis, but individuals with more extensive disease and more obvious symptoms showed a shorter delay.RESUMO CONTEXTO: O diagn óstico da doença inflamatória intestinal é frequentemente retardado pela falta de capacidade para reconhecer as suas principais manifestações clínicas. OBJETIVO: Nosso estudo teve como objetivo descrever as manifestações...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
NEW YORK (AP) — A bigger share of U.S. drug overdose deaths are being caused by methamphetamine, government health officials reported. The number of fatal overdoses involving meth more than tripled between 2011 and 2016, the Centers for Disease Control and Prevention reported Wednesday. The percentage of overdose deaths involving meth grew from less than 5 percent to nearly 11 percent. Meth is not the main killer among illicit drugs. Fentanyl was involved in the highest percentage of fatal overdoses in 2016, followed by heroin and cocaine. Meth was fourth. But it was only eighth as recently as 2012. It's not clear wh...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care News Source Type: news
Conditions:   Multiple Sclerosis;   Quality of Life;   Motivation;   Pain;   Headache;   Migraine;   Anxiety Disorders;   Depressive Disorder;   Sleep Disorder;   Insomnia;   Physical Disability;   Fatigue Intervention:   Behavioral: Exercise training Sponsor:   University of Rijeka Enrolling by invitation
Source: - Category: Research Source Type: clinical trials
Abstract IntroductionCancer-related drowsiness (CRD) is a distressing symptom in advanced cancer patients (ACP). The aim of this study was to determine the frequency and factors associated with severity of CRD. We also evaluated the screening performance of Edmonton Symptom Assessment Scale-drowsiness (ESAS-D) item against the Epworth Sedation Scale (ESS). METHOD: We prospectively assessed 180 consecutive ACP at a tertiary cancer hospital. Patients were surveyed using ESAS, ESS, Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Hospital Anxiety Depression Scale.ResultNinety of 150 evaluable patients had...
Source: Palliative and Supportive Care - Category: Palliative Care Authors: Tags: Palliat Support Care Source Type: research
AbstractBackgroundPrescription opioid use at high doses or over extended periods of time is associated with adverse outcomes, including dependency and abuse. The aim of this study was to identify mediating variables that predict chronic opioid use, defined as three or more prescriptions after orthopedic surgery.MethodsIndividuals were ages between 18 and 50  years and undergoing arthroscopic hip surgery between 2004 and 2013. Two categories of chronic opioid use were calculated based on individuals (1) having three or more unique opioid prescriptions within 2 years and (2) still receiving opioid prescriptions>...
Source: Perioperative Medicine - Category: Surgery Source Type: research
Publication date: Available online 20 November 2018Source: BurnsAuthor(s): Ali Najafi, Hamid Zeinali Nejad, Naemeh NikvarzAbstractObjectivesTo evaluate efficacy of addition of duloxetine to usual analgesic regimens in management of burn pain.MethodsIn a 3-week open label randomized controlled trial, burn patients were assigned to the intervention (duloxetine 60 mg/day + usual analgesic regimens) or control group (usual analgesic regimens: morphine ± acetaminophen ± gabapentin). Intensity and quality of background pain and severity of procedural pain were evaluated using neur...
Source: Burns - Category: Dermatology Source Type: research
ConclusionAs cannabis legalization has impacted the variety of cannabis products available, there appears to be growing numbers of PwMS using cannabis, with this study's CUs reporting use of highly efficacious products with minimal side-effects.
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
ConclusionAbout 41.5% of study participants had at least three symptoms of PCS. Occupation, cause of injury and location of injury were significantly associated with the occurrence of PCS.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
Conclusion: Dara-CyBorD was active and well tolerated in pts with ND and RMM, including pts with high-risk cytogenetics. ORR, VGPR+, and CR rates improved with cycles 5-8 of induction, indicating that longer therapy with dara results in deeper response. Preliminary PFS and OS data in ND pts in the first year are comparable to dara-VMP. The safety profile was consistent with that previously reported for dara, with no new safety signals observed. Split first daratumumab dosing was feasible, reduced Day 1 infusion time, and resulted in a similar IR rate as previously described for single-dose administration. These findings in...
Source: Blood - Category: Hematology Authors: Tags: 653. Myeloma: Therapy, excluding Transplantation: Novel Antibody Combinations in Myeloma Source Type: research
This study also examines whether there is a G-CSF dose threshold above which there is a significant increase in skeletal pain and other acute toxicities from mobilization without an appreciable increase in progenitor cell yield.Methods. The primary outcome was examination of CD34+ per liter of blood processed (x106/L) on Day 5 of G-CSF administration as a measure of collection yield. The secondary outcomes were the incidence of skeletal pain and highest toxicity level across selected body symptoms (fatigue, nausea, anorexia, insomnia, dizziness) at 24 hours after first G-CSF dose, day 1 to 5 of G-CSF administration, 2 days...
Source: Blood - Category: Hematology Authors: Tags: 711. Cell Collection and Processing II Source Type: research
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