Analgesia for office hysteroscopy: systematic review & meta-analysis

Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Prathiba M. De Silva, Ayesha Mahmud, Paul P. Smith, T. Justin ClarkAbstractObjectiveTo identify the most effective analgesia for women undergoing office hysteroscopy.Data sourcesMedline, Embase, CINAHL and the Cochrane library were searched from inception until August 2019 investigating the effect of different analgesics on pain control in office hysteroscopy.Methods of study selectionRandomised controlled trials were included that investigated the effect of analgesics on pain experienced by women undergoing diagnostic or operative hysteroscopy in an office setting compared to a control.Tabulation, Integration and ResultsThe literature search returned 561 records. 22 studies were selected for systematic review, of which 16 were suitable for meta-analysis. There was a statistically significant reduction in pain during office hysteroscopy associated with pre-procedural administration of non-steroidal anti-inflammatory drugs (NSAID) (SMD -0.72, 95% CI -1.27 to -0.16), opioids (SMD -0.50, 95% CI -0.97 to -0.03) and antispasmodics (SMD -1.48, 95% CI -1.82 to -1.13), as well as with the use of transcutaneous electrical nerve stimulation (TENS) (SMD -0.99, 95% CI -1.67 to -0.31), compared to a control. Similar reductions in pain following office hysteroscopy were also observed; NSAID (SMD -0.55, 95% CI -0.97 to -0.13), opioids (SMD -0.73, 95% CI -1.07 to -0.39), antispasmodic...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research

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ConclusionWhile these practices were implemented because of sound biologic plausibility or encouraging observational data, well-done RCTs have failed to show evidence of effectiveness. These examples raise caution in introducing new clinical interventions into widespread clinical practice without sufficient high quality evidence demonstrating efficacy.
Source: Current Therapeutic Research - Category: Drugs & Pharmacology Source Type: research
Publication date: Available online 22 February 2020Source: Neuroscience LettersAuthor(s): Yan Liu, Zhiwei Zhang, Xiaofen Lu, Jian Meng, Xuying Qin, Jie JiangAbstractEndometriosis of sciatic nerve is a common gynecological disease. Here we aimed to study the anti-inflammatory and anti-nociceptive role of sulforaphane on sciatic nerve endometriosis. The sciatic nerve endometriosis rat model was constructed by autologous implantation of uterine tissue. Sulforaphane was administered intraperitoneally at the dose of 5, 15, 30 and 60 mg/kg/day for 28 days. Behavioral testing was performed at day 7, 14, 21 and 28. At day 2...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
In this study, olfactory ensheathing cells (OECs) were cultured, chitosan (CS) was prepared, and the compatibility of CS and OECs was detected by MTT method. Animal model of chronic constrictive sciatic nerve injury (CCI) was made, OECs and OECs+CS were transplanted to the region surrounding the chronic sciatic nerve injury, and the difference between the two groups in the treatment of NPP was compared. The mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured by using behavioral method. In situ hybridization and Western-blotting were used to detect the expression of P2X4R mRNA and protei...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
Conclusions: The proposed web-based deep learning approach can be very practical and accurate for spine segmentation as a diagnostic method. PMID: 32082701 [PubMed]
Source: Healthcare Informatics Research - Category: Information Technology Tags: Healthc Inform Res Source Type: research
Conclusions: NeckProtector can be an alternative treatment for neck pain self-management via smartphone application among smartphone users with neck pain. Further studies should examine the long-term effectiveness (Clinical trials registry: TCTR20160523001). PMID: 32082700 [PubMed]
Source: Healthcare Informatics Research - Category: Information Technology Tags: Healthc Inform Res Source Type: research
Authors: Herold A Abstract Hemorrhoidal disease is one of the most common illnesses in industrialized nations. Up to 70% of adults suffer from the disease once in their lifetime. This underlines the necessity and importance of knowing about the differential diagnosis of hemorrhoids. One can differentiate between differential diagnoses of symptoms (bleeding, pain, itching, tumor) and differential diagnoses of the phenotype findings (anal prolapse, mucosal prolapse and rectal prolapse, skin tags, hypertrophied anal papillae, condylomata acuminata, anal fissure, perianal venous thrombosis, anal cancer). PMID: 3207...
Source: Der Hautarzt: Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete - Category: Dermatology Tags: Hautarzt Source Type: research
CONCLUSIONS: Given increasing rates of opioid addiction and death, viable solutions are universally needed. Successful intervention measures should be widely shared between military, veteran, and civilian healthcare and public health communities. Increased collaboration between these groups could inculcate successful programs to prevent and decrease opioid use. Results received from recent military and veterans' programs for prescription and electronic medical record (EMR) monitoring and data sharing may also prove useful for civilian healthcare providers and hospital systems. Future evaluations from ongoing federally fund...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
This study evaluated self-reported knee pain (KP) and its effect on physical performance during military service in the Estonian Defense Forces. MATERIAL AND METHODS: Ninety-five male conscripts aged 19-25 years were divided into two study groups based on the occurrence of KP or not. Self-reported KP and function according to the Knee Injury and Osteoarthritis Outcome Score (KOOS) were measured. Physical fitness level was scored using the Army Physical Fitness Test (APFT). KOOS and APFT were measured in the beginning and at the end of the 6-month period of military service. RESULTS: Significant differences in ...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Authors: Yarushkina NI, Filaretova LP Abstract The preconditioning effect of a mild stressor can reduce the ulcerogenic effect of a severe stressor on the gastric mucosa. The aim of the study was to investigate the effect of preconditioning stress on the gastric and the small intestinal injury caused by a single injection of indomethacin (IM) in conscious rats. Preliminary fasting (24 hours) rats were subjected IM administration (35 mg/kg, subcutaneously) with preconditioning stress (30 min cold-restraint at 10°C and further 1 hour keeping in cages at room temperature) or without stress. Plasma corticosterone l...
Source: Journal of Physiology and Pharmacology - Category: Drugs & Pharmacology Tags: J Physiol Pharmacol Source Type: research
ConclusionThe combination of these two fracture types is uncommon and has not been previously reported. Our report suggests that in cases of a proximal humerus fracture resulting from a high-energy mechanism, the surgeon should obtain an X-ray or perform fluoroscopy with the patient in the upright or semi-upright position before surgery to avoid missing an AC joint injury.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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