Nyfödda barn som är kroniskt eller tillfälligt sjuka upplever multipla invasiva och vävnadsskadande procedurer på akutmottagningar och intensivvårdsavdelningar. Smärtsamma procedurer är en risk för hjärnskador hos den nyfödde. Den här litteraturstudien hade som syfte att beskriva den smärtlindrande effekten av sockerlösning i samband med smärtsamma procedurer hos nyfödda samt att beskriva möjliga komplement till administrering av sockerlösning. Vidare var syftet att beskriva de valda artiklarnas design. Artiklarna hämtades från databasen PubMed genom sökord i olika kombinationer. Undersökningsgruppen var tillfälligt sjuka samt friska nyfödda barn. Artiklarna bearbetades noggrant genom att läsas igenom med fokus på resultatdelen. Resultatet av de granskade artiklarna visar att sockerlösningen har en god effekt på smärta hos nyfödda när den jämförs med placebo eller sterilt vatten. I studier som jämfört sockerlösningen med metoder som att den nyfödda fick suga, fick värme eller hud mot hud så har sockerlösningen en sämre effekt på smärta hos nyfödda. Ett resultat talade helt emot att använda sig av sockerlösning till nyfödda i smärtlindrande syfte. Komplement till sockerlösning i smärtlindrande syfte, som t ex att den nyfödda fick värme, hud mot hud eller fick suga tillsammans med sockerlösning gav bättre effekter än att ge endast sockerlösning. Resultatet visade även att bröstmjölk (inte genom amning) har en sämre effekt jämfört med sockerlösning avseende smärta, men när den nyfödda fick amma visades det motsatta. Författarens tredje frågeställning beskriver ett resultat där de flesta studier har en liknande design, dock ser strukturen för hur man presenterat sin design olika ut mellan de olika studierna. / Newborn babies who are chronically or temporarily ill are experiencing multiple invasive and noxious procedures in emergency rooms and intensive care units. Painful procedures are a risk of brain damage in newborn. This literature review aims to describe the analgesic effect of the sugar solution during painful procedures in neonates and to describe possible complement to the administration of sugar solution. A further aim was to describe the selected articles design. Studies retrieved from the database PubMed by keywords in various combinations. The study group was temporarily ill and healthy babies. Articles were processed carefully by being read with a focus on results section. The results of the reviewed articles show that the sugar solution has a good effect on pain in newborns when compared with placebo or sterile water. In studies that compared the sugar solution with methods that newborn babies were sucking, got heat or skin to skin so the sugar has a worse effect on pain in neonates. One result speaks totally against the use of sugar solution to newborn for pain-relieving. Complement to the sugar solution in purpose of pain relief, such as the newborn got warmth, skin to skin or got sucking in combination with sugar solution provides better effects than giving only the sugar solution. A result also show that breast milk (not through breastfeeding) has a worse effect than sugar solution in pain, but when the newborn babies were breast-feeds the opposite was shown. The author`s third question describes a performance were most studies has a similar design, but the structure of how it has been presented differs between the different studies.

Circumstances of an increasing proportion of elderly persons in the population of the United States and the incidence of pain among elderly persons established the need for this research project. Significant to nurses was the lack of information regarding responses to the pain experience and evidence of inadequate pain control. The purpose of this study was to explore the relationship between pain and coping strategies used by a group of elderly persons experiencing pain and living in long-term-care facilities. The population included individuals residing in long-termcare facilities in Indiana. A convenience sample of 36 persons from six facilities in central Indiana participated in the study.Gate Control Theory of pain and Lazarus' theory of stress and coping were the theoretical frameworks of the study. The independent variable, pain, was measured by two Parts of the McGill Pain Questionnaire, pain rating index andpain intensity. Coping, the dependent variable, was measured by the Ways of coping checklist; scoring methods yielded coping, problemfocused coping, emotion-focused coping, and eight subscales. Data was collected by the researcher through use of these two instruments and interviews. Pearson product moment correlations were used for statistical analysis.There were no significant correlations between pain intensity and coping measures. There were no significant correlations between pain rating and coping and emotionfocused coping. Additional findings were based on the data analysis with coping subscales. There was a significant positve correlation between pain rating and the coping subscale escape-avoidance. There was a significant negative correlation between pain rating and the coping subscale distancing.Results of the study indicated elderly individuals experiencing pain used several coping strategies. This finding is consistent with research involving elderly persons living in the community. / School of Nursing

Neste estudo padronizamos modelo de dor óssea induzida pela administração de células do tumor de Walker 256 em fêmur de ratos e avaliamos o efeito analgésico da crotalfina, um peptídeo com atividade analgésica. Análises radiográficas, tomográficas e cintilográficas demonstraram a presença de processos osteolíticos difusos, destruição do tecido cortical ósseo e intensa atividade osteogênica. Foi detectado aumento de partes moles adjacentes ao osso, fenômeno observado em pacientes com câncer ósseo. Análises histopatológicas mostraram a presença de células tumorais no pulmão, baço e fígado dos animais, indicando disseminação das células tumorais. Foi detectada a presença de hiperalgesia, alodinia e dor manifesta, a partir do 1º dia após a inoculação das células, persistindo por pelo menos 14 dias. Crotalfina (8 <font face=\"Symbol\">mg/kg, p.o) administrada no 14º dia, bloqueou estes fenômenos. Esse efeito antinociceptivo é de longa duração (48 h) e mediado por receptores opióides do tipo <font face=\"Symbol\">k e <font face=\"Symbol\">d. Não foi observado desenvolvimento de tolerância após o tratamento prolongado com crotalfina. / The aim of the present work was to standardize a new rat model of bone pain induced by the injection of Walker 256 carcinoma cells into the femoral cavity of rats, and to evaluate the analgesic effect of crotalphine, an analgesic peptide. Radiographic, tomographic and scintigraphic analysis showed the presence of diffuse osteolytic processes, destruction of cortical bone tissue and intense osteogenic activity. Increase of soft tissue adjacent to the bone was also detected, being this phenomenon observed in patients with bone cancer. Hystopathological analysis showed the presence of tumor cells in lungs, spleen and liver, indicating the occurrence of metastasis. Tumor cell inoculation induced the presence of hyperalgesia, allodynia and spontaneous pain. Crotalphine (8 <font face=\"Symbol\">mg/kg, p.o.), administered on day 14, blocked these phenomena. This antinociceptive effect is long-lasting effect (2 days) and mediated by peripheral <font face=\"Symbol\">k and <font face=\"Symbol\">d- opioid receptors. Prolonged treatment with crotalphine (14 days) did not cause the development of tolerance to its antinociceptive effect.

A coerência do processo de fabricação, via granulação úmida, de comprimidos de dipirona sódica (500 mg) foi avaliada empregando ferramentas de qualidade e de estatística. No estudo foi desenvolvida base racional-científica objetivando determinar as etapas críticas do processo por meio da técnica de análise de modo e efeito da falha (FMEA). A análise de risco revelou as potenciais falhas do processo: variação da distribuição granulométrica da mistura final com elevado percentual de pó fino e problemas relativos a fluidez; ensaios de peso, espessura, dureza, friabilidade, tempo de desintegração e dissolução fora de especificação; não-uniformidade do conteúdo de dipirona sódica (OS) na mistura final e durante a compressão e ocorrência de laminação, capeamento, porosidade e aderência dos comprimidos às estações da máquina compressora. Os métodos analíticos relativos à determinação de (OS), empregando metodologia espectrofotométrica e de cromatografia líquida de alta eficiência (CLAE), foram previamente validados. As seguintes características de desempenho, em ambas metodologias analíticas, foram determinadas: especificidade, linearidade com coeficiente de correlação (r) &#62; 0,99, repetibilidade aceitável com desvio padrão relativo (OPR) &#60; 2% e precisão intermediária entre analistas e em dias diferentes. Além disso, a robustez e exatidão com percentual de recuperação entre 99,28% e 100,84% foram comprovadas para o método de CLAE. No que se refere às etapas críticas da validação do processo produtivo, foi elaborado plano de amostragem baseado nos critérios estabelecidos em compêndio oficial (FARMACOPÉIA BRASILEIRA, 1988), Guia da FOA (UNITEO STATES, 2003), duração de cada etapa de fabricação e tipo de equipamento utilizado. Além disso, foi empregada a lista Millitary Standard 105E (TAYLOR, ENTERPRISES, 1989). Os resultados relativos à estabilidade estatística do processo revelaram ausência de causas especiais. Os índices de capacidade Cp e Cpk foram calculados após avaliação da distribuição dos dados empregando teste de Anderson-Darling. Todos os dados apresentaram distribuição normal (p &#62; 0,05), exceto àqueles relativos à uniformidade de conteúdo de OS na etapa de compressão. Esses dados foram tratados utilizando método proposto por Box-Cox (Iambda igual a 5) visando sua normalização. Os índices de capacidade Cp e Cpk. revelaram resultados &#62; 1 e, portanto, permitiram determinar a consistência do processo e baixa probabilidade de falha. / The consistency of the metamizol tablets (500 mg) manufacturing process, via wetting granulation, was evaluated by quality and statistical tools. In this study, rational-scientific base was developed aiming determination of the critical steps of this process, using the Failure Mode and Effects Analysis (FMEA) technique. The risk analysis shows the potential failures of the process: variability of particle size distribution, high percentage of fine powder and flowability problems related to the final mixture; weight, thickness, hardness, friability, disintegration time and dissolution percentage of the tablets out-of-specifications; non-uniformity of the metamizol content in the final mixture and during the tabletting steps; laminating, capping, porosity and sticking of the tablets. The analytical methods performed by spectrophotometric and high performance liquid chromatography (HPLC), in order to assay metamizol, were previously validated. The following parameters were evaluated in both analytical methodologies: specificity, linearity with correlation coefficients more than 0.99, acceptable repeatability with relative standard deviation (RSD) less than 2% and intermediate precision between two different analysts and days. Besides that, the system suitability and accuracy were also proved by HPLC method. The recoveries obtained were between 99.28% and 100.84%. The sampling plan was elaborated according to official compendium (FARMACOPEIA BRASILEIRA, 1988), FOA Guidance (UNITED STATES, 2003), Military Standard 105E (TAYLOR ENTERPRISES, 1989), the duration of each step and the type of equipment used. This plan was just applied for critical steps identified by FMEA tool. The results related to the statistical stability of the process show no special cause. The capability indexes, Cp and Cpk, were calculated after the evaluation of the data distribution using Anderson-Darling test. Ali data showed normal distribution (p &#62; 0.05), except for uniformity of metamizol content of the tablets. This data was treated by a method proposed by Box-Cox (Iambda equal -5.0) aimed at obtaining the normality of the data. The capability indexes, Cp and Cpk, obtained were all &#62; 1. Therefore, this process can be considered consistent and with low probability of failures.

<p><font face="Tahoma"> <p align="left">The purpose of this study is to evaluate the need for prophylactic antibiotic treatment in third molar surgery and to establish specific guidelines for antibiotic prophylaxis in the department of Maxillo-Facial and Oral Surgery (MFOS) at Tygerberg Academic, Groote Schuur and Mitchells Plain Hospitals.</p> </font></p>

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 150-161).

published_or_final_version / Anaesthesiology / Master / Doctor of Medicine

published_or_final_version / Pharmacology and Pharmacy / Doctoral / Doctor of Philosophy

Syfte: Syftet med denna studie var att jämföra graden av smärta och illamående hos två patientgrupper inom ortopedi som smärtlindrades med tablett Dolcontin/Depolan/Morfin eller tablett Oxycontin/Oxynorm postoperativt dag 0, 1 och 2. Syftet var även att undersöka vilka riskfaktorer enligt Apfel Risk Score som kan påverka grad av illamående samt att undersöka om en korrelation fanns mellan preoperativ information och incidensen av postoperativt illamående och kräkning (PONV). Metod: En komparativ studie med kvantitativ ansats. Data samlades in genom två olika enkäter, varav en enkät fylldes i av patienterna och en enkät av sjuksköterskorna. 48 patienter inkluderades i studien, 24 per substans. Både kvinnor och män som genomgått elektiva knä- eller höftarteroplastikoperationer deltog i studien och de var mellan 31-77 år. Mätinstrumentet som sjuksköterskorna använde sig av för att skatta smärta och illamående var visuell analog skala (VAS). Data analyserades i Statistic Package for the Social Science (SPSS) 10.1 med x2-test, oberoende t-test samt Mann-Whitney U-test. Resultat: Resultatet i studien visade att inte fanns någon signifikant skillnad gällande smärta och de två substanserna. Det fanns en signifikant skillnad gällande illamående och de två substanserna. Inget signifikant samband påvisades mellan illamående och riskfaktorerna i Apfel Risk Score. Det fanns heller inget signifikant samband mellan incidensen av PONV och patientens upplevelse av att ha fått noggrann information preoperativt. Slutsats: Då dokumentationen av smärta och illamående enligt VAS på sjuksköterskeenkäterna var bristfällig, kan inga säkra slutsatser dras. Mer forsknings krävs således inom detta område. / Aim: The aim of this study was to compare the rating of pain and nausea in two groups of patients in orthopedics that was pain relieved with tablet Dolcontin/Depolan/Morphine or tablet Oxycontin/Oxynorm postoperative day 0, 1 and 2. The aim was also to investigate the risk factors according to Apfel Risk Score that may affect the degree of nausea and to investigate whether a correlation existed between preoperative information and the incidence of postoperative nausea and vomiting (PONV). Method: A comparative study with quantitative approach. Data were collected through two different questionnaires, one that was filled out by the patients and the other questionnaire by the nurses. The study included 48 patients, 24 per substance. Both men and women, between 31-77 years old, who would undergo elective knee or hip replacement surgery, participated in the study. The measuring instrument that the nurses used to estimate the pain and nausea were visual analogue scale (VAS). Data were analyzed in the Statistic Package for the Social Science (SPSS) 10.1 with the x2-test, independent t-test and Mann-Whitney U-test. Results: The results of the study showed that there was no significant difference regarding pain and the two compounds. There was a significant difference regarding nausea and the two compounds. No significant correlation was found between nausea and the risk factors in the Apfel Risk Score. There was no significant correlation between the incidence of PONV and patient experience of receiving accurate information preoperatively. Conclusion: As the documentation of pain and nausea according to VAS on the nursing surveys were poor, no firm conclusions can be drawn. Further studies are necessary to confirm the results of this study.

Objective: To evaluate the consumption of analgesics in Lithuania in the year 2005 – 2007. Material and methods: The data on sales of analgesics drugs in Lithuanian over a 3-year period (2005 – 2007) were obtained from Softdent database. Data were calculated by defined daily dose (DDD) methodology and expressed in DDDs per 1000 inhabitants per day. Results: The total analgesic drugs consumption increased by 16.55% in a 3-year period (2005 – 2007): from 58.37 DDDs/1000 inhabitants/day to 68.03 DDDs/1000 inhabitants/day. Diclofenac (ATC M01A) seemed to be the most highly consumed drug in Lithuania in the three-year period. Diclofenac (M01A) price/DDD is only 0.28 Lt. For these reasons diclofenac was more often used than other painkillers. The second most used agent for pain control was glucosamine (6.38 DDDs/1000 inhabitants/day in 2005), which is used for the treatment of osteoarthritis and, along with new products, its popularity increased sharply. Its consumption grew by 29.80% and achieved 8.28 DDDs/1000 inhabitants/day in 2007. Glucosamine value (Price/DDD) is 1.39 Lt, while paracetamol - 0.59 Lt. Glucosamine is OTC drug so people can buy it easily without control. Maybe for this reasons the usage of glucosamine is enough high. Ibuprofen has regained its popularity after the problems with coxibs. In 2005, the consumption of ibuprofen (4.42 DDDs/1000 inhabitants/day) grew rapidly once again, reached 7.26 DDDs/1000 inhabitants/day in 2007 and showed 64.25% increase... [to full text] / Tikslas. Įvertinti analgetikų vartojimo tendencijas Lietuvoje 2005 – 2007 m. Metodai. Duomenys apie analgetikų pardavimą Lietuvoje 2005 – 2007 metais rinkti iš UAB „Softdent" duomenų bazės. Vaistai buvo klasifikuojami pagal anatominę terapinę cheminę (ATC) klasifikaciją. Vaistų suvartojimas buvo vertinamas pagal apibrėžtos dienos dozės (DDD – angl. defined daily dose) metodiką, o duomenys pateikiami apibrėžta dienos doze tūkstančiui gyventojų. Rezultatai. Lietuvoje per trejus metus (2005 – 2007) analgetikų vartojimas padidėjo 16.55%: nuo 58.37 iki 68.03 DDD/tūkstančiui gyventojų. Daugiausiai buvo suvartojama diklofenako (ATC grupė M01A), tai galėjo būtų dėl tam tikrų priežasčių: diklofenako vieno DDD kaina tik 0.28 lito. Antroje vietoje pagal suvartojimą – gliukozaminas, kuris vartojamas osteoartritui gydyti. Jo suvartojimas išaugo 29.80% ir 2007 m. pasiekė 8.28 DDD/tūkstančiui gyventojų. Gliukozamino vieno DDD vertė 1.39 Lt, kai paracetamolio – 0.59 Lt. Gliukozaminas yra bereceptis vaistas, taigi žmonėms jis legvai prieinamas. Galbūt dėl šių priežasčių gliukozamino suvartojama gana daug. Ibuprofenas susigrąžino savo populiarumą: 2005 metais jo suvartojimas pradėjo vėl sparčiai didėti, 2007 metais pasiekė 7.26 DDD/tūkstančiui gyventojų, ir parodė 64.25% augimą. Nimesulido vartojimas dramatiškai išaugo ir 2007 metais pasiekė 4.91 DDD/tūkstančiui gyventojų. Jo vieno DDD vertė 1.69 Lt, kai paracetamolio ir kitų analgetikų ši vertė nesiekė 1 Lt. Airijoje nimesulidas buvo... [toliau žr. visą tekstą]