| 1. |
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| 2. |
- Alisic, E., et al.
(författare)
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The Role of an Assistant Nurse in Implementing the WHO Surgical Safety Checklist: Perception and Perspectives
- 2023
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Ingår i: Cureus Journal of Medical Science. - 2168-8184. ; 15:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The World Health Organization (WHO) Surgical Safety Checklist is a tool developed by the WHO to promote safer surgical practices and reduce the incidence of surgical errors and complications. This study aims to describe the role of assistant nurses in the implementation of this checklist by surgical teams. Materials and methods This descriptive study utilized a questionnaire-based survey conducted between September 2018 and March 2019 among 196 healthcare professionals at two surgical units in a university hospital in Sweden. The questionnaire covered demographic information such as age, gender, and occupation, as well as details about their workplace, experience, education/training on using the WHO checklist, the adaptation of the checklist to their department, their responsibilities in implementing and using the checklist, the frequency of use in emergency situations, and the impact on patient safety. Results The results of the study showed that assistant nurses, despite having the lowest level of education among healthcare professionals, were highly trusted and valued by other members of the surgical team. Most healthcare professionals were unsure who was responsible for using the WHO checklist but believed it was the assistant nurse's responsibility to ensure its implementation. Assistant nurses reported little to no training on using the checklist but noted that it had been adapted to the department's needs. Almost half (48.8%) of assistant nurses believed that the checklist was often used in emergency surgery, and most believed that it improved patient safety. Conclusions Improved understanding of the significance of assistant nurses in implementing the WHO Surgical Safety Checklist may enhance adherence to the checklist and potentially improve patient safety, as they were the most valued and trusted healthcare professionals in the surgical team according to the study's findings.
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| 3. |
- Apostolidi, Dimitra Maria, et al.
(författare)
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Neonatal Palliative Care as an Integral Component of the Greek National Healthcare System: Time to Act
- 2023
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Ingår i: Cureus. - : SPRINGERNATURE. - 2168-8184. ; 15:9
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Neonatal palliative care aims to provide multidisciplinary support to families and neonates suffering from life-threatening or life-limiting diseases. Many countries worldwide have recognized the importance of enhancing the quality of life in critically ill neonates and thus have created and systematically implemented palliative care protocols in neonatal intensive care units (NICUs). Europe has a very low neonatal mortality rate, which has been steadily decreasing over the last 30 years. Greece in particular, a country located in Southeast Europe, reported a neonatal mortality rate of 2.29/1,000 live births in 2020. Nevertheless, neonatal palliative care facilities are scarce on a national level. In this paper, several reasons are presented to support the integration of neonatal palliative care in the Greek national healthcare system with the vision to ensure that all neonates and their families will receive in the near future the care, support, and dignity they deserve when facing life-threatening or life-limiting illnesses.
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| 4. |
- Busuttil, Nicolette, et al.
(författare)
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Medical Note Quality Audit at the Vascular Surgical Unit Compared With the British Medical Journal (BMJ) Guidelines
- 2023
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Ingår i: Cureus. - : Springer Nature. - 2168-8184. ; 15:12
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Tidskriftsartikel (refereegranskat)abstract
- Effective medical notes ensure comprehensive documentation in healthcare. This study evaluates medical note quality in the vascular unit at Mater Dei Hospital using British Medical Journal (BMJ) guidelines. Two cycles examine 17 parameters pre- and post-intervention, revealing notable, significant enhancements in patient identifiers, clinical summaries, examination, and planning. Future prospects involve digitizing notetaking, utilizing artificial intelligence (AI) for data organization, and simplifying entry methods. Implementation of electronic solutions is encouraged for improved accuracy, efficiency, and continuity of patient care.
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| 5. |
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| 6. |
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| 7. |
- Corell, Alba, et al.
(författare)
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Intracranial Manifestation of Melioidosis: A Case Report and Long-Term Follow-Up
- 2020
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Ingår i: Cureus. - : Cureus, Inc.. - 2168-8184. ; 12:12
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Tidskriftsartikel (refereegranskat)abstract
- Primary neurological melioidosis is rare with fewer than 50 cases reported world-wide. We report the first documented case of primary neurological melioidosis in Sweden, a 32-year old male who previously lived in Thailand for six years and recently moved to Sweden. He presented with headache, irritability and lack of concentration. Investigation with computerized tomography (CT) and subsequent magnetic resonance imaging (MRI) showed epidural fluid that was interpreted as a chronic epidural hematoma. He underwent surgical evacuation of the epidural collection that was found to be a white collection mixed with pus and bacterial culture results were positive for Burkholderia pseudomallei.
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| 8. |
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| 9. |
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| 10. |
- Jaffe, J Douglas, et al.
(författare)
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Bone Cement Implantation Syndrome: Incidence and Associated Factors in a United States Setting.
- 2022
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Ingår i: Cureus. - 2168-8184. ; 14:11
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of bone cement implantation syndrome (BCIS) following cemented hemiarthroplasty for the treatment of hip fracture in the United States (US) population is not previously described. We sought to describe the incidence and factors associated with BCIS as well as its impact on mortality.In this retrospective observational study, electronic health records were examined for all relevant cases and BCIS was identified and graded according to accepted criteria. Demographic data was collected and an adjusted Cox proportional model was performed to determine the impact of severe BCIS on mortality.Following exclusions for documentation error and misclassification, 69 patients were included in the final analysis. BCIS, regardless of grade, was present in 24 (35%) patients, while severe BCIS (grades 2 and 3) was found in 7 (10%) of patients. Cox proportional hazard estimation adjusted for American Society of Anesthesiologists (ASA) grade, male sex, and age did not show severe BCIS to be independently associated with mortality, hazard ratio (CI) 1.96 (0.22-17.22).The incidence of BCIS in a selected hip fracture population is comparable in the US to those found in European studies. This study did not establish the occurrence of BCIS with mortality. As cemented hemiarthroplasty is recommended for displaced hip fractures and its use escalates in the US, one can expect an increase in the absolute number of patients experiencing BCIS as well.
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| 11. |
- Karapiperis, Dimitrios, et al.
(författare)
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Eosinophinc Esophagitis and Gastroesophageal Reflux Disease : An Overlapping of Clinical, Endoscopic and Manometric Features
- 2021
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Ingår i: Cureus. - : Cureus Inc.. - 2168-8184. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- The cause of eosinophilic esophagitis (EoE) is not well understood. Most patients with EoE have allergic disorders. Here, we describe a patient with gastroesophageal reflux and EoE with dysphagia, substemal discomfort and retrostemal pain. Based on symptomatology consistent with gastroesophageal reflux disease (GERD), treatment started with proton pump inhibitors (PP1s) but no effect was observed. Next, the patient underwent esophagogastroduodenoscopy and multiple biopsies were acquired from the lower and upper esophagus. Cortisone treatment was given and high-resolution manometry was performed before and after treatment. The results suggested that esophageal motility improved after cortisone therapy together with improvements in the clinical and histological pictures.
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| 12. |
- Lundqvist, Martina, et al.
(författare)
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Cost-Effectiveness of the Use of Gold Anchor (TM) Markers in Prostate Cancer
- 2020
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Ingår i: Cureus. - : CUREUS INC. - 2168-8184. ; 12:10
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A common treatment for prostate cancer is external beam radiation therapy. A way to target the radiation is to use implantable gold fiducial markers (GFMs). The GFMs serve as reference points enabling tumor localization during treatment. Today, there are several GFMs available on the market but no clinical guidelines as to which one to use. The aim of this study was to estimate the cost-effectiveness of Gold Anchor GFMs (Naslund Medical AB, Huddinge, Sweden) implanted with a 22G needle, compared to other GFMs implanted with a 17-18G needle, in the prostate gland of patients with prostate cancer. Methods Costs, life years, and quality-adjusted life years (QALYs) were estimated over a lifelong time horizon for each treatment strategy using a decision-analytic model. Data used in the model were obtained from published literature or were estimated by an expert elicitation technique. The primary outcome measure was an incremental cost-effectiveness ratio (ICER). Results Gold Anchor GFM was found to be a dominant alternative with both lower costs [-8.7 US Dollars (USD)] and a gain in QALYs (0.015) when compared with other GFMs. The lower cost was achieved by fewer visits for imaging in treatment planning, and by reduced risk of infections and sepsis. The QALY gain was driven by a reduced risk of sepsis. Conclusion The use of Gold Anchor GFMs as reference points to target radiation is a cost-effective alternative when compared to other GFMs. However, this analysis is based on expert elicitation regarding some crucial parameters, and further clinical studies of the use of GFMs are needed.
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| 13. |
- Magnusson, Peter, et al.
(författare)
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Current Knowledge of Hypertrophic Cardiomyopathy Among Health Care Providers in Sweden
- 2020
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Ingår i: Cureus. - PALO ALTO : Cureus, Inc.. - 2168-8184. ; 12:12
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Hypertrophic cardiomyopathy (HCM) is a common disorder with various manifestations, including sudden cardiac death. Patients with suspected or confirmed HCM may be encountered throughout the healthcare system, especially in internal medicine and cardiology. Thus, thorough knowledge of HCM is essential among healthcare providers.Methods: A web-based questionnaire was developed to assess the cross-sectional evaluation of HCM knowledge. It covered aspects such as epidemiology and diagnosis, treatment, lifestyle, risk stratification of sudden cardiac death, and implantable cardioverter-defibrillator knowledge.Results: In total, 123 subjects completed the survey. The mean age was 38.5 ±10.7 years and two-thirds (n=82) were females; 43.1% were physicians (non-specialist 24.4%, cardiologists 8.9%, specialist, other than cardiology 9.8%); and the remaining were nurses (nurses within cardiology 37.4%, nurses outside cardiology 19.5%). Almost all subjects had heard about the disease (95.9%) and the vast majority (77.2%) had taken part in the management of a patient with HCM. The total mean score was 15.9 ±3.9 credits and the 25th, 50th, and 75th percentiles were 14, 15, and 18 credits, respectively. The predefined arbitrary pass score of ≥60% was reached by 61.8%, and 20.3% were considered to pass with distinction. Physicians scored higher than nurses (70.7 ±17.0% vs 58.1 ±11.8; p<0.001). Within each professional category, there was a similar score with regard to gender.Conclusions: There is a considerable lack of knowledge of HCM among healthcare professionals working within the field of internal medicine/cardiology. This insufficient knowledge may contribute to less implementation of evidence-based medicine and current guidelines, although further studies are needed to confirm this.
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| 14. |
- Magnusson, Peter M., et al.
(författare)
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The Sex Data Gap Within Implantable Cardioverter Defibrillator (ICD) Studies : A Retrospective Study of Literature From 1980 Until 2022
- 2023
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Ingår i: Cureus. - : Springer Nature. - 2168-8184. ; 15:7
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Tidskriftsartikel (refereegranskat)abstract
- Implantable cardioverter defibrillators (ICDs) are a form of cardiac therapy used to prevent death in patients at risk for sudden heart failure. Using 100 articles from the introduction of ICDs until now, a retrospective literature review was conducted. These studies were analyzed for sex disparity over the past 40 years. The difference in the number of male participants to female participants was statistically significant for both the earlier and later study groups (p = 0.0014 and p = 0.0004 respectively), indicating a significant and consistently lower number of females in ICD research over time. This review shows no significant difference in the sex disparity since the implementation of ICDs. Unfortunately, due to a gap in the literature, the reason for this disparity between the sexes in ICD literature can only be speculated. This disparity may be partly due to a lack of incentive and encouragement for women to participate in research.
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| 15. |
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| 17. |
- Mitropoulou, Maria-Andriani, et al.
(författare)
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Quality of Life in Patients With Inflammatory Bowel Disease : Importance of Psychological Symptoms
- 2022
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Ingår i: Cureus. - : Cureus, Inc.. - 2168-8184. ; 14:8
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Tidskriftsartikel (refereegranskat)abstract
- Background Depressive, anxiety, and stress symptoms are prevalent in patients with inflammatory bowel disease (IBD) and may negatively influence the disease course and quality of life. The study aimed to assess the relationship between psychological factors and patients’ quality of life (QoL).Materials and methods A cross-sectional study with the use of a structured questionnaire among 38 patients with Crohn’s disease and 30 with ulcerative colitis was conducted. The inflammatory bowel disease questionnaire (IBDQ-32) was used to evaluate the patients’ quality of life, and the Depression, Anxiety, Stress Scale (DASS21) was used to evaluate these psychological factors. Pearson descriptive statistics and multiple regression analyses were performed.Results According to the findings of the multiple regression analysis, depressive, anxiety, and stress symptoms were negatively associated with quality of life. Participants with higher scores of anxiety had inferior QoL in intestinal symptoms (p=0.013) and in systemic symptoms (p=0.013), with higher scores of depression had inferior QoL in emotional function (p<0.001), and higher scores of stress had inferior QoL in the domain of social support (p=0.002). Psychological symptoms of emotional disorders appear to be associated with lower quality of life in IBD patients.Conclusion This study examined levels of depression, anxiety, and stress in Greek patients with IBD, which were associated with lower levels of their quality of life. Interventions to improve QoL in patients with IBD should consider the effect of psychological symptoms.
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| 18. |
- Olsson, Hanna, et al.
(författare)
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Physiological Effects of Beetroot in Athletes and Patients
- 2019
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Ingår i: Cureus. - : CUREUS INC. - 2168-8184. ; 11:12
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Forskningsöversikt (refereegranskat)abstract
- Dietary supplementation with beetroot juice (BRJ), a naturally rich source of nitrate, is an area of considerable interest to elite athletes as well as recreational exercisers. Nitrate and nitrite have previously been thought of as mainly final elimination products of nitric oxide (NO), but this view has been challenged and evidence indicates that these compounds can be converted to NO in vivo. We conducted a narrative review summarizing the literature regarding evidence of beetroot used as dietary supplement and its effects on training physiology and athletic performance in healthy and diseased populations. The databases PubMed and Web of Science were used to obtain articles. It was evident that BRJ supplementation had an effect on oxygen cost and consumption during exercise by more efficient adenosine triphosphate (ATP) production in combination with lower ATP consumption. However, the effect seems to be dependent on dose and duration. Effect on exercise performance is conflicting, time to exhaustion seems to increase but its effect on time-trial performance needs further elucidation. Ergogenic benefits might depend on individual aerobic fitness level, where individuals with lower fitness level may gain higher benefits regarding athletic performance. Dietary nitrate supplementation appears to have some effect on training performance in patients with peripheral artery disease, heart failure, and chronic pulmonary obstructive disease. However, larger randomized controlled trials are necessary to determine the overall utility of beetroot as a dietary supplement.
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| 19. |
- Panagopoulos, Andreas, et al.
(författare)
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Cross-Cultural Adaptation of the Greek Versions of the Lysholm Knee Scoring Scale and Tegner Activity Scale
- 2020
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Ingår i: Cureus. - : Cureus. - 2168-8184. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The Lysholm Knee Scoring Scale (LKSS) and the Tegner Activity Scale (TAS) are widely used instruments for assessing knee function and activity level in various knee pathologies, especially knee ligament injuries. The purpose of this study was to translate and crossculturally adapt the Greek versions of the Lysholm Knee Scoring Scale (Gr-LKSS) and Tegner Activity Scale (Gr-TAS) and assess their reliability and validity in Greek patients suffering from various knee problems. Materials and methods Translation of the LKSS and TAS questionnaires was done according to established international guidelines. Fifty-five patients (32 males and 23 females; mean age: 24 +/- 7 years; range: 17-54 years) with various knee pathologies completed the Gr-LKSS and Gr-TAS along with the Greek versions of International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) and the Oxford Knee Score (OKS). Test-retest reliability was evaluated with the intraclass correlation coefficient (ICC) in 53 (96%) individuals, who completed the questionnaires again after 48-72 hours while abstaining from all forms of treatment. Internal consistency for the Gr-LKSS was measured using Cronbach’s alpha and criterion-related validity was evaluated with the Pearson’s correlation coefficient (r) in relation to control questionnaires (IKDC, KOS-ADLS, OKS). The distribution of floor and ceiling effects were also determined. Results There were no problems during the forward-backward translation and cultural adaptation of the Gr-LKSS and Gr-TAS. Criterion-related validity was confirmed with moderate to high associations of Gr-LKSS and Gr-TAS (after injury) with the IKDC and KOS-ADLS (Pearson’s r ranging between 0.61-0.71 and 0.64-0.73, respectively). However, weak correlations were yielded between both questionnaires with the OKS (r=0.14-0.19). The internal consistency for Gr-LKSS was high (Cronbach’s alpha: 0.779) and the test-retest reliability was high for both questionnaires (Gr-LKSS: ICCm3.950; Gr-TAS before and after injury: ICCs of 0.877 and 0.876, respectively). Conclusion The cultural adaptation and validity of Gr-LKSS and Gr-TAS were successfully accomplished. These questionnaires are recommended for use in the evaluation of soft tissue knee disorders in both clinical practice and research.
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| 20. |
- Parikh, Riya R., et al.
(författare)
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Effects of Digoxin in Heart Failure (HF) With Reduced Ejection Fraction (EF)
- 2022
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Ingår i: Cureus. - : Cureus Inc.. - 2168-8184. ; 14:3
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Forskningsöversikt (refereegranskat)abstract
- In this review, we evaluated the literature on the benefits and deleterious effects of digoxin in heart failure (HF) with reduced ejection fraction (EF). Although digoxin was considered an effective treatment for HF, the supporting evidence is conflicting. Before the conventional use of modern HF therapies, digoxin was widely used for symptomatic relief on these patients. Further randomized trials are required to reach a definite conclusion about its efficacy and safety in patients experiencing HF with a reduced EF (HFrEF).
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| 21. |
- Parikh, Riya R., et al.
(författare)
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The Use of Monoclonal Antibody-Based Proprotein Convertase Subtilisin-Kexin Type 9 (PCSK9) Inhibitors in the Treatment of Hypercholesterolemia
- 2022
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Ingår i: Cureus. - : Cureus Inc.. - 2168-8184. ; 14:6
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Forskningsöversikt (refereegranskat)abstract
- In this review, we evaluated several studies in the literature to analyze the benefits and deleterious effects of the use of monoclonal antibodies (MABs)-based proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors in patients with hypercholesterolemia. Increased low-density lipoprotein cholesterol (LDL-C) levels lead to an increase in the risk of cardiovascular (CV) disease. Statins are the cornerstones of hypercholesterolemia treatment, but the patient response may often vary, and additional therapies may be needed to control the increased LDL-C levels. MABs bind to PCSK9 receptors, causing a reduction in LDL-C levels. MAB-based PCSK9 inhibitors such as alirocumab and evolocumab have been approved for use in hypercholesterolemia in combination with statins. Studies have suggested that both alirocumab and evolocumab are effective in lowering LDL-C levels, have favorable side effect profiles, and can be administered at convenient dosing intervals; however, further double-blind, randomized trials evaluating the long-term safety and efficacy of both the agents could assist with clinical decision-making.
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| 22. |
- Pergolizzi, Joseph, et al.
(författare)
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Cocaethylene : When Cocaine and Alcohol Are Taken Together
- 2022
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Ingår i: Cureus. - : Cureus, Inc.. - 2168-8184. ; 14:2
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Forskningsöversikt (refereegranskat)abstract
- Cocaine is taken frequently together with ethanol and this combination produces a psychoactive metabolite called cocaethylene which has similar properties to the parent drug and may be more cardiotoxic. Cocaethylene has a longer half-life than cocaine, so that people who combine cocaine and ethanol may experience a longer-lasting, as well as more intense, psychoactive effect. Cocaethylene is the only known instance where a new psychoactive substance is formed entirely within the body. Although known to science for decades, cocaethylene has not been extensively studied and even its metabolic pathways are not entirely elucidated. Like its parent drug, cocaethylene blocks the reuptake of dopamine and increases post-synaptic neuronal activity; the parent drug may also block reuptake of serotonin as well. Cocaethylene has been studied in animal models in terms of its pharmacology and its potential neurological effects. Since the combination of cocaine and alcohol is commonly used, it is important for clinicians to be aware of cocaethylene, its role in prolonging or intensifying cocaine intoxication, and how it may exacerbate cocaine induced cardiovascular disorders. Most cardiac-related risk assessment tools do not ask about cocaine use, which can prevent clinicians from making optimal therapeutic choices. Greater awareness of cocaethylene is needed for clinicians, and those who use cocaine should also be aware of the potential for polysubstance use of cocaine and ethanol to produce a potentially potent and long-lasting psychoactive metabolite.
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| 23. |
- Pergolizzi, Joseph, et al.
(författare)
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Considerations for Pain Assessments in Cancer Patients : A Narrative Review of the Latin American Perspective
- 2023
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Ingår i: Cureus. - : Cureus Inc.. - 2168-8184. ; 15:6
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Forskningsöversikt (refereegranskat)abstract
- Cancer incidence in Latin America is lower than in Europe or the United States but morbidity and mortality rates are disproportionately high. A barrier to adequate pain control is inadequate pain assessment, which is a relatively easy and inexpensive metric. The objective of this narrative review is to describe pain assessment for cancer patients in Latin America. Cultural factors may influence pain perception, including contextualizing pain as noble or natural suffering and aspects of what is now called "spiritual pain." Unlike other painful conditions, cancer pain may be strongly associated with existential fear, psychosocial distress, anxiety, and spiritual concerns. Pain assessment allows not just quantification of pain intensity but may elucidate pain mechanisms involved or psychosocial aspects that may color the pain. Many current pain assessment instruments capture only pain intensity, which is but one aspect of the pain experience; some have expanded to include functional assessments, mental health status evaluations, and quality of life metrics. A quality-of-life assessment may be appropriate for cancer patients since chronic pain can severely impact function, which can in turn create a vicious cycle by exacerbating pain. The incidence of cancer in Latin America is expected to increase in the ensuing years. Better pain assessment and clinician education are needed to help manage pain in this large and growing patient population.
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| 24. |
- Pergolizzi, Joseph, et al.
(författare)
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Exploring the Implications of New-Onset Diabetes in COVID-19 : A Narrative Review
- 2023
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Ingår i: Cureus. - : Cureus Inc.. - 2168-8184. ; 15:1
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Forskningsöversikt (refereegranskat)abstract
- Post-viral new-onset diabetes has been an important feature of the COVID-19 pandemic. It is not always clear if new-onset diabetes is the unmasking of a previously undiagnosed condition, the acceleration of prediabetes, or new-onset diabetes that would not have otherwise occurred. Even asymptomatic cases of COVID-19 have been associated with new-onset diabetes. Diabetes that emerges during acute COVID-19 infection tends to have an atypical presentation, characterized by hyperglycemia and potentially life-threatening diabetic ketoacidosis. It is not always clear if new-onset diabetes is type 1 or type 2 diabetes mellitus. Many cases of COVID-associated diabetes appear to be type 1 diabetes, which is actually an autoimmune disorder. The clinical course varies temporally and with respect to outcomes; in some cases, diabetes resolves completely or improves incrementally after recovery from COVID-19. Disruptions in macrophagy caused by COVID-19 infection along with an exaggerated inflammatory response that can occur in COVID-19 also play a role. Those who survive COVID-19 remain at a 40% elevated risk for diabetes in the first year, even if their case of COVID-19 was not particularly severe. A subsequent post-pandemic wave of new diabetes patients may be expected.
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| 25. |
- Pergolizzi, Joseph, et al.
(författare)
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Fixed Dose Versus Loose Dose : Analgesic Combinations
- 2023
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Ingår i: Cureus. - : Springer Nature. - 2168-8184. ; 15:1
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Forskningsöversikt (refereegranskat)abstract
- Combinations of drugs may be fixed (two or more entities in a single product) or loose (two or more agents taken together but as individual agents) to help address multimechanistic pain. The use of opioids plus nonopioids can result in lower opioid consumption without sacrificing analgesic benefits. Drug combinations may offer additive or synergistic benefits. A variety of fixed-dose combination products are available on the market such as diclofenac plus thiocolchicoside, acetaminophen and caffeine, acetaminophen and opioid, ibuprofen and acetaminophen, tramadol and acetaminophen, and others. Fixeddose combination products offer predictable pharmacokinetics and pharmacodynamics, known adverse events, and can reduce the pill burden. However, they are limited to certain drug combinations and doses; loose dosing allows prescribers the versatility to meet individual patient requirements as well as the ability to titrate as needed. Not all drug combinations offer synergistic benefits, which depend on the drugs and their doses. Certain drugs offer dual mechanisms of action in a single molecule, such as tapentadol, and these may further be used in combination with other analgesics. New technology allows for co-crystal productions of analgesic agents which may further improve drug characteristics, such as bioavailability. Combination analgesics are important additions to the analgesic armamentarium and may offer important benefits at lower doses than monotherapy.
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