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  1. Article ; Online: Impact of Geodemographic Factors on Antibiotic Prescribing for Acute, Uncomplicated Bronchitis or Upper Respiratory Tract Infection.

    Dilworth, Thomas J / Hietpas, Kayla / Kram, Jessica J F / Baumgardner, Dennis

    Journal of the American Board of Family Medicine : JABFM

    2022  Volume 35, Issue 4, Page(s) 733–741

    Abstract: Objective: To assess the impact of geodemographic factors on antibiotic prescribing for adult acute, uncomplicated bronchitis or upper respiratory tract infection.: Methods: A retrospective, observational study of 63,051 single health-system, ... ...

    Abstract Objective: To assess the impact of geodemographic factors on antibiotic prescribing for adult acute, uncomplicated bronchitis or upper respiratory tract infection.
    Methods: A retrospective, observational study of 63,051 single health-system, outpatient discharges with a primary diagnosis of bronchitis or upper respiratory tract infection in 2019. Univariate analyses of prescribing predictors and multivariable stepwise logistic modeling were performed.
    Results: Patients who were older (aOR 1.02; 95% CI 1.02, 1.02), male (1.10; 1.06, 1.14), black (1.29; 1.22, 1.38), smoked (1.18; 1.14, 1.23), seen in urgent care (1.26; 1.22, 1.31) and living in an area with more owner-occupied housing (1.41; 1.30, 1.53) were more likely to receive antibiotics. Patients who were Asian (0.88; 0.77, 0.99), had Medicare (0.83; 0.78, 0.87), Medicaid (0.84; 0.79, 0.87) or Exchange insurance (0.90; 0.82, 0.98), or seen in the emergency department (0.43; 0.40, 0.46) were less likely to receive antibiotics. Distance from a patient's address and their encounter location did not predict antibiotic prescribing.
    Conclusions: Antibiotic prescribing interventions for adult acute bronchitis and upper respiratory tract infections could target patients living in an area with higher socioeconomic status.
    MeSH term(s) Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Bronchitis/drug therapy ; Humans ; Inappropriate Prescribing ; Male ; Medicare ; Practice Patterns, Physicians' ; Respiratory Tract Infections/drug therapy ; Retrospective Studies ; United States
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-07-27
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 2239939-2
    ISSN 1558-7118 ; 1557-2625
    ISSN (online) 1558-7118
    ISSN 1557-2625
    DOI 10.3122/jabfm.2022.04.210452
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2626: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Opioid-Free Analgesia is Safe and Effective in Anterior Cervical Spine Surgery: A Randomized Controlled Trial.

    Segebarth, P Bradley / Schallmo, Michael / Odum, Susan / Hietpas, Kayla / Michalek, Caleb / Chapman, T Matthew / Leas, Daniel / Milam, R Alden / Hamid, Nady

    Clinical spine surgery

    2024  Volume 37, Issue 4, Page(s) 138–148

    Abstract: Study design: Randomized controlled trial (RCT).: Objective: Compare the efficacy of a multimodal, opioid-free (OF) pain management pathway with a traditional opioid-containing (OC) pathway in patients undergoing anterior cervical procedures.: ... ...

    Abstract Study design: Randomized controlled trial (RCT).
    Objective: Compare the efficacy of a multimodal, opioid-free (OF) pain management pathway with a traditional opioid-containing (OC) pathway in patients undergoing anterior cervical procedures.
    Summary of background data: Previous studies have compared opioid-based pain regimens to opioid-sparing regimens following cervical spine surgery, but have been limited by high rates of crossover, retrospective designs, reliance on indwelling pain catheters, opioid utilization for early postoperative analgesia, and/or a lack of patient-reported outcome measures.
    Methods: This is a RCT in which patients were allocated to either an OF or OC perioperative pain management protocol. Eligible study participants included adult (age up to 18 y) patients who underwent primary, 1-level or 2-level anterior cervical surgery [anterior cervical discectomy and fusion (ACDF), anterior cervical disc arthroplasty (ACDA), or hybrid (ACDF and ACDA at different levels)] for degenerative pathology. The primary outcome variable was subjective pain level at 24 hours postoperative. The final study cohort consisted of 50 patients (22 OF, 28 OC).
    Results: Patients in the OF group reported lower median postoperative pain levels at 6 hours (4 for OF vs. 7 for OC; P =0.041) and 24 hours (3 for OF vs. 5 for OC; P =0.032). At 2-week and 6-week follow-up, pain levels were similar between groups. Patients in the OF group reported greater comfort at 12 hours (9 for OF vs. 5 for OC; P =0.003) and 24 hours (9 for OF vs. 5 for OC; P =0.011) postoperatively. Notably, there were no significant differences in patients' reported pain satisfaction, overall surgical satisfaction, or overall sense of physical and mental well-being. In addition, there were no significant differences in falls, delirium, or constipation postoperatively.
    Conclusions: A multimodal OF pain management pathway following anterior cervical surgery for degenerative disease results in statistically noninferior pain control and equivalent patient-reported outcome measures compared with a traditional OC pathway.
    MeSH term(s) Humans ; Male ; Female ; Cervical Vertebrae/surgery ; Middle Aged ; Pain, Postoperative/etiology ; Pain, Postoperative/drug therapy ; Analgesics, Opioid/therapeutic use ; Adult ; Treatment Outcome ; Pain Management ; Pain Measurement ; Analgesia ; Spinal Fusion/adverse effects
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2024-03-28
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2849646-2
    ISSN 2380-0194 ; 2380-0186
    ISSN (online) 2380-0194
    ISSN 2380-0186
    DOI 10.1097/BSD.0000000000001608
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2427: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Opioid-Free Analgesia Provides Pain Control Following Thumb Carpometacarpal Joint Arthroplasty.

    Hysong, Alexander A / Odum, Susan M / Lake, Nicholas H / Hietpas, Kayla T / Michalek, Caleb J / Hamid, Nady / Gaston, Raymond G / Loeffler, Bryan J

    The Journal of bone and joint surgery. American volume

    2023  Volume 105, Issue 22, Page(s) 1750–1758

    Abstract: Background: We hypothesized that an opioid-free (OF), multimodal pain management pathway for thumb carpometacarpal (CMC) joint arthroplasty would not have inferior pain control compared with that of a standard opioid-containing (OC) pathway.: Methods!# ...

    Abstract Background: We hypothesized that an opioid-free (OF), multimodal pain management pathway for thumb carpometacarpal (CMC) joint arthroplasty would not have inferior pain control compared with that of a standard opioid-containing (OC) pathway.
    Methods: This was a single-center, randomized controlled clinical trial of patients undergoing primary thumb CMC joint arthroplasty. Patients were randomly allocated to either a completely OF analgesic pathway or a standard OC analgesic pathway. Patients in both cohorts received a preoperative brachial plexus block utilizing 30 mL of 0.5% ropivacaine that was administered via ultrasound guidance. The OF group was given a combination of cryotherapy, anti-inflammatory medications, acetaminophen, and gabapentin. The OC group was only given cryotherapy and opioid-containing medication for analgesia. Patient-reported pain was assessed with use of a 0 to 10 numeric rating scale at 24 hours, 2 weeks, and 6 weeks postoperatively. We compared the demographics, opioid-related side effects, patient satisfaction, and Veterans RAND 12-Item Health Survey (VR-12) results between these 2 groups.
    Results: At 24 hours postoperatively, pain scores in the OF group were statistically noninferior to, and lower than, those in the OC group (median, 2 versus 4; p = 0.008). Pain scores continued to differ significantly at 2 weeks postoperatively (median, 2 versus 4; p = 0.001) before becoming more similar at 6 weeks (p > 0.05). No difference was found between groups with respect to opioid-related side effects, patient satisfaction, or VR-12 results.
    Conclusions: A completely opioid-free perioperative protocol is effective for the treatment of pain following thumb CMC joint arthroplasty in properly selected patients.
    Level of evidence: Therapeutic Level I . See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Humans ; Pain Management/methods ; Analgesics, Opioid/therapeutic use ; Carpometacarpal Joints/surgery ; Thumb/surgery ; Pain, Postoperative/drug therapy ; Analgesics/therapeutic use ; Analgesia/methods ; Arthroplasty, Replacement, Hip/methods
    Chemical Substances Analgesics, Opioid ; Analgesics
    Language English
    Publishing date 2023-08-31
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.22.01278
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.58/1: Show issues Location:
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    Zs.MO 464: Show issues

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