Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Angiostrongylus cantonensis is a parasite that causes eosinophilic meningitis and has been reported to be present on most Pacific islands. Rats are the principal host and several species of land snails the intermediate host. Important paratenic hosts are fresh water shrimp and fish. Modes of transmission include ingestion by man of raw fish, snails and fresh leafy vegetables contaminated by snail slime trails containing larvae. The parasitic worms are neurotropic in man, and the diagnosis should be considered in any adult or child, who presents, in endemic areas or areas with suitable intermediate hosts, with severe unrelenting headache, paresthesias, or a cranial nerve palsy. Eosinophils in the cerebral spinal fluid suggest the diagnosis. Simple analgesia is sufficient for mild cases. Treatment of those with severe symptoms remains controversial. Glucocorticoids, lumbar puncture to reduce intercranial pressure and antihelminthic agents have been used.
Pac Health Dialog 2001 Mar
PMID:Human infections with Angiostrongylus cantonensis. 1201 20

Data derived from a large cohort of hemodialysis patients (12,896) undergoing dialysis access maintenance procedures being performed by interventional nephrologists were analyzed to determine the safety of sedation/analgesia (S/A) in a freestanding facility. Data collected included patient demographics, procedures performed, time of procedures, drugs used, doses used, and complications that occurred. Four high-risk groups were identified based upon age, pulmonary status, and over all physical status. These were compared to the total cohort. Midazolam, fentanyl, or a combination of the two were used. Within the total cohort of patients, midazolam alone was used most commonly (94.7%). The total mean dose of midazolam when used alone was 3.4 mg. The dosages used in the high-risk groups tended to be only slightly lower (3-3.2 mg). This setting appears to be safe for hemodialysis patients, even those in high-risk subgroups having these types of procedures. The types of drugs and the dosages that are commonly used do not appear to be associated with an unacceptable risk to the hemodialysis patient. A nephrologist that is not specialty trained in anesthesia is able to provide S/A safely in a freestanding facility.
Semin Dial
PMID:The risk of sedation/analgesia in hemodialysis patients undergoing interventional procedures. 2133

The aim of this study was to assess postoperative opioid prescribing patterns, usage, and pain control after common vascular surgery procedures in order to develop patient centered best-practice guidelines. We performed a prospective review of opioid prescribing after seven common vascular surgeries at a rural, academic medical center from December 2016 to July 2017. A standardized telephone questionnaire was prospectively administered to patients ( n = 110) about opioid use and pain management perceptions. For comparison we retrospectively assessed opioid prescribing patterns ( n = 939) from July 2014 to June 2016 normalized into morphine milligram equivalents (MME). Prescribers were surveyed regarding opioid prescription attitudes, perceptions, and practices. Opioids were prescribed for 78% of procedures, and 70% of patients reported using opioid analgesia. In the prospective group, the median MMEs prescribed were: VEIN (31, n = 16), CEA (40, n = 14), DIAL (60, n = 17), EVAR (108, n = 8), INFRA (160, n = 16), FEM TEA (200, n = 11), and OA (273, n = 4). The median proportion of opioids used by patients across all procedures was only 30% of the amount prescribed across all procedures (range 14-64%). Patients rated the opioid prescribed as appropriate (59%), insufficient (16%), and overprescribed (25%), and pain as very well controlled (47%), well controlled (47%), poorly controlled (4%), and very poorly controlled (2%). In conclusion, we observed significant variability in opioid prescribing after vascular procedures. The overall opioid use was substantially lower than the amount prescribed. These data enabled us to develop guidelines for opioid prescribing practice for our patients.
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PMID:Postoperative opioid prescribing patterns and use after vascular surgery. 3044 60