Methods.
Information about patients was obtained from chart review.
Outcome Measures. Benefits and side effects of treatment, as well as the process of prescribing opioids and follow-up.
Results. In the four patients studied, there seem to be better pain control and improved function in these patients while on opioid therapy, despite minor side effects. We identified some areas of improvement MK-8931 datasheet in our practice and made recommendations for the use of opioids in pediatric chronic severe nonmalignant pain.
Conclusions. The evolution of our four patients seems to be in favor of treatment with an opioid for severe chronic nonmalignant pain in certain pediatric patients, in the context of prescribing in a multidisciplinary pain clinic with a multisystem approach to pain management although HIF inhibitor more data are needed to know if such therapy is safe and beneficial on a longer-term basis.”
“Objectives: It is currently unclear whether the parallels between abdominal aortic aneurysms (AAAs) and chronic obstructive pulmonary disease (COPD) are explained by common risk factors alone, such as cigarette smoking, or by a predetermined cause. Given the persistent controversy with regard
to the association between AAA and COPD, we studied this association in depth.
Methods: We conducted a case control study comparing patients with a small AAA (maximum infrarenal diameter 35-50 mm, n = 221) with controls diagnosed with peripheral artery disease (PAD, n = 87). The controls were matched to the cases for lifetime cigarette smoking. Pulmonary function was measured by spirometry, and all subjects completed a questionnaire on medical history and smoking habits (current, former and never smokers).
Results: Aneurysm patients were similar to controls with Aurora Kinase inhibitor respect to gender (p = 0.71), lifetime cigarette smoking
(39 vs. 34 pack years, p = 0.23) and history of cardiovascular disease (45% vs. 55%, p = 0.12). Aneurysm patients had more airway obstruction (forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) (0.69 +/- 0.12 vs. 0.78 +/- 0.11, p < 0.001)), which was most pronounced in never smokers (0.73 +/- 0.07 vs. 0.86 +/- 0.07, p < 0.001). COPD was more prevalent in aneurysm patients (44%; 98/221) than in controls (20%; 17/87) (adjusted odds ratio (OR) 3.0; 95% confidence interval (95%CI) 1.6-5.5, p < 0.001). In particular, a major proportion of AAA patients was newly diagnosed with COPD; only 40 of 98 patients (41%) with COPD (mild, moderate or severe/very severe) were known before with obstructive pulmonary defects and received treatment.
Conclusions: This study confirms an association between AAA and COPD and shows that this association is independent from smoking. Findings also demonstrate that COPD is under-diagnosed in AAA patients. (C) 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.