scholarly journals Retrospective cohort study on pain management using global standard-dose acetaminophen in 182 patients treated for cancer pain

2011 ◽  
Vol 6 (2) ◽  
pp. 133-142
Author(s):  
Masanori Kawahara ◽  
Takeshi Okabe
Keyword(s):  
Cohort Study ◽  
Pain Management ◽  
Cancer Pain ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Standard Dose

scholarly journals Neurotoxic Concentration of Piperacillin during Continuous Infusion in Critically Ill Patients

2017 ◽  
Vol 61 (9) ◽  
Author(s):  
Marie-Charlotte Quinton ◽  
Sandra Bodeau ◽  
Loay Kontar ◽  
Yoann Zerbib ◽  
Julien Maizel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Serum Concentration ◽  
Retrospective Cohort Study ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
Standard Dose ◽  
Neurologic Disorder ◽  
Concentration Threshold

ABSTRACT This retrospective cohort study included 53 patients admitted to the intensive care unit (ICU), with an average age of 69 years, without neurologic disorder before initiation of a continuous piperacillin infusion at the standard dose and who underwent piperacillin serum concentration monitoring. Among them, 23 developed a neurologic disorder for which the piperacillin causality was chronologically and semiologically suggestive. A concentration threshold of 157.2 mg/liter independently predicted neurotoxicity with 96.7% specificity and 52.2% sensitivity and may constitute a limitation when targeting less susceptible pathogens.

Relationship Between Tramadol Response and Cancer Cachexia: A Retrospective Cohort Study

2020 ◽  
pp. 104990912094557
Author(s):  
Kayoko Morio ◽  
Kazuhiro Yamamoto ◽  
Ikuko Yano
Keyword(s):  
Cohort Study ◽  
Cancer Pain ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cancer Cachexia ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Patients With Cancer ◽  
Logistic Analysis ◽  
Cell Counts

Objective: It was reported that the administration of tramadol in patients with cancer pain who have a higher interleukin 6 (IL-6) serum level led to insufficient pain relief. Cytokines produced by tumors, including IL-6, are associated with cancer cachexia. However, whether nonresponse to tramadol is related to cancer cachexia is unknown. The purpose of this study was to examine the relationship between tramadol response and cancer cachexia in patients with cancer pain. Methods: We conducted a retrospective cohort study of patients with cancer who received tramadol treatment for mild to moderate pain from January 2016 to June 2019. Patients who experienced <20% pain reduction based on the numeric rating scale from baseline to day 7 after treatment with tramadol were defined as nonresponders. Univariate and multivariate logistic regression analyses were conducted to examine the relationships between tramadol response and various patient characteristics, including cancer cachexia. Results: Of 115 patients, 79 were included in the analysis. A total of 24 patients experienced cancer cachexia, and 22 patients were nonresponders. In the univariate logistic analysis, cancer cachexia (odds ratio [OR]: 6.04, 95% confidence interval [CI]: 2.06-17.7), higher white blood cell counts (× 103/μL; OR: 1.28, 95% CI: 1.04-1.61), and lower body mass index (OR: 0.79, 95% CI: 0.66-0.96) were significantly associated with nonresponse to tramadol. The multivariate logistic analysis revealed that cancer cachexia (OR: 5.27, 95% CI: 1.75-15.9) was the only significant factor associated with nonresponse to tramadol. Conclusions: Cancer cachexia in patients with cancer pain can be associated with nonresponse to tramadol.

scholarly journals Examining opioid prescribing trends for non-cancer pain using an estimated oral morphine equivalence measure: a retrospective cohort study between 2005 and 2015

BJGP Open ◽  
2020 ◽  
pp. bjgpopen20X101122
Author(s):  
Emma Davies ◽  
Bernadette Sewell ◽  
Mari Jones ◽  
Ceri J Phillips ◽  
Jaynie Y Rance
Keyword(s):  
Cohort Study ◽  
Cancer Pain ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Oral Morphine ◽  
Annual Number ◽  
Alternative Measure ◽  
Supporting Evidence ◽  
Opioid Prescribing ◽  
Prescribing Trends

BackgroundOver the past 20 years prescription of opioid medicines has markedly increased in the UK, despite a lack of supporting evidence for use in commonly occurring, painful conditions. Prescribing is often monitored by counting numbers of prescriptions dispensed, but this may not provide an accurate picture of clinical practice.AimTo use an estimated oral morphine equivalent (OMEQe) dose to describe trends in opioid prescribing in non-cancer pain, and explore if opioid burden differed by deprivation status.Design & settingA retrospective cohort study using cross-sectional and longitudinal trend analyses of opioid prescribing data from Welsh Primary Care General Practices (PCGP) took place. Data were used from the Secure Anonymised Information Linkage (SAIL) databank.MethodAn OMEQe measure was developed and used to describe trends in opioid burden over the study period. OMEQe burden was stratified by eight drug groups, which was based on usage and deprivation.ResultsAn estimated 643 436 843 milligrams (mg) OMEQe was issued during the study. Annual number of prescriptions increased 44% between 2005 and 2015, while total daily OMEQe per 1000 population increased by 95%. The most deprived areas of Wales had 100 711 696 mg more OMEQe prescribed than the least deprived over the study period.ConclusionOver the study period, OMEQe burden nearly doubled, with disproportionate OMEQe prescribed in the most deprived communities. Using OMEQe provides an alternative measure of prescribing and allows easier comparison of the contribution different drugs make to the overall opioid burden.

Mexiletine Usage in a Chronic Pain Clinic: Indications, Tolerability, and Side Effects

2018 ◽  
Vol 1 (21;1) ◽  
pp. E573-E579 ◽  
Author(s):  
Adam Romman
Keyword(s):  
Chronic Pain ◽  
Neuropathic Pain ◽  
Cohort Study ◽  
Pain Management ◽  
Side Effects ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Diagnosis ◽  
Pain Clinic ◽  
Chronic Pain Management

Background: Background: Intravenous lidocaine has multiple applications in the management of acute and chronic pain. Mexiletine, an oral lidocaine analogue, has been used in a number of chronic pain conditions although its use is not well characterized. Objectives: To report our experience using mexiletine in a chronic pain population, specifically looking at tolerability, side effects, and EKG changes. Study Design: Retrospective, cohort study. Setting: Multiple pain clinic locations in an integrated multispecialty health system. Methods: All patients who had a mexiletine prescription between August 2015 and August 2016 were queried via the electronic medical record. Each chart was examined for demographics, QTc changes on EKG, length of use, and reasons for stoppage. Results:There were 74 total patients identified in the chronic pain management clinics as receiving at least 1 mexiletine prescription over the 1-year time period. Twice as many women as men received mexiletine prescriptions. Neuropathic pain was the most common primary diagnosis (64%) which included diabetic neuropathy, radiculopathy, and others. Fibromyalgia was the next most common primary diagnosis (28%). A QTc change on the EKG showed a mean decrease of 0.1 ms and median increase of 1.5 ms. At 6 months (180 days), approximately 30% of the patients remained on mexiletine therapy, and 28% remained on the therapy at 1 year (360 days). Median duration of use was 60 days and the mean was 288 days. Neurologic and gastrointestinal side effects were the most commons reason for stoppage. All side effects were mild and resolved with stoppage. After side effects, lack of response, or loss of efficacy, were the next most common reasons for stoppage. Limitations: Pain relief and outcomes were not specifically examined due to confounding factors including interventional treatments and multiple treatment modalities. This was a retrospective, cohort study limited to our specific clinic population with a relatively high loss to follow-up rate. Conclusion:Mexiletine is rarely a first line option for chronic pain management and is often used when multiple other modalities have failed. By reporting our experience, we hope other clinicians may have more familiarity with the drug’s use in a chronic pain practice. It appears reasonably tolerable, may not require frequent EKG monitoring, and can be an appropriate adjunct in the chronic pain population. More research is needed regarding efficacy and dose titration for mexiletine in chronic pain. Key Words: Chronic pain, mexiletine, IV lidocaine, pain, neuropathic pain, neuropathy, fibromyalgia, QTc, tolerability

Standard-Dose Versus High-Dose Acyclovir in Children Treated Empirically for Encephalitis: A Retrospective Cohort Study of Its Use and Safety

2014 ◽  
Vol 16 (3) ◽  
pp. 229-234 ◽  
Author(s):  
Jennifer G. Kendrick ◽  
Mary H. H. Ensom ◽  
Andrew Steer ◽  
Colin T. White ◽  
Eddie Kwan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Standard Dose ◽  
High Dose

scholarly journals Pain management in photodynamic therapy: A retrospective cohort study

2020 ◽  
Vol 82 (2) ◽  
pp. 483-484
Author(s):  
James W.L. Denny ◽  
Alberto Barea ◽  
David Wertheim ◽  
Natasha Valiallah ◽  
Janakan Natkunarajah
Keyword(s):  
Cohort Study ◽  
Photodynamic Therapy ◽  
Pain Management ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

scholarly journals Managing Cancer Pain at the End of Life with Multiple Strong Opioids: A Population-Based Retrospective Cohort Study in Primary Care

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e79266 ◽  
Author(s):  
Wei Gao ◽  
Martin Gulliford ◽  
Michael I. Bennett ◽  
Fliss E. M. Murtagh ◽  
Irene J. Higginson
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Cancer Pain ◽  
End Of Life ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Strong Opioids
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