Sauerkeene0930

Propranolol is a non-selective beta-adrenergic receptor antagonist. A multicenter, randomized, double-blind, placebo-controlled, parallel-group, phase 2b trial enrolled participants aged 18-65 years with temporomandibular disorder (TMD) myalgia to evaluate efficacy and safety of propranolol compared with placebo in reducing facial pain. Participants were randomized 11 to either extended-release propranolol hydrochloride (60 mg, BID) or placebo. The primary endpoint was change in facial pain index (FPI = facial pain intensity multiplied by facial pain duration, divided by 100). Efficacy was analyzed as a mean change in FPI from randomization to week 9 and as the proportion of participants with ≥30% or ≥50% reductions in FPI at week 9. Regression models tested for treatment-group differences adjusting for study site, sex, race, and FPI at randomization. Of 299 participants screened, 200 were randomized; 199 had at least one post-randomization FPI measurement and were included in intention-to-treat analysis. At week 9, model-adjusted reductions in mean FPI did not differ significantly between treatment groups (-1.8, 95%CL -6.2, 2.6; P=0.41). Selleck Olaparib However, the proportion with a ≥30% reduction in FPI was significantly greater for propranolol (69.0%) than placebo (52.6%), and the associated number-needed-to-treat (NNT) was 6.1 (P=0.03). Propranolol was likewise efficacious for a ≥50% reduction in FPI (NNT=6.1, P=0.03). Adverse event rates were similar between treatment groups, except for more frequent fatigue, dizziness, and sleep disorder in the propranolol group. Propranolol was not different from placebo in reducing mean FPI but was efficacious in achieving ≥30% and ≥50% FPI reductions after 9 weeks of treatment among TMD participants.OBJECTIVE The aim of this study was to assess the effect of an enhanced recovery after surgery (ERAS) pathway on pain and opioid use following lung resection. SUMMARY BACKGROUND DATA A major component ERAS pathways is opioid-sparing analgesia; however, the effect on postoperative pain and opioid use in patients undergoing lung resection is unknown. METHODS Following implementation of an ERAS pathway for lung resection, 123 consecutive patients were identified. Patients were propensity-matched 11 with a group of consecutive patients (n = 907) undergoing lung resection before ERAS. Differences regarding in-hospital opioid consumption, discharge prescribing of opioids, and postoperative pain scores were examined. Morphine milligram equivalents were separately calculated including and excluding tramadol as an opioid medication. RESULTS There were no significant differences between matched patients regarding age, sex, performance status, receipt of preoperative treatment, extent of lung resection, or operative appventional management.OBJECTIVE To evaluate the performance changes after sequential bilateral cochlear implantation in a pediatric population of bimodal cochlear implant (CI) users. To evaluate the factors which influence the parental and recipient decision to discontinue hearing aid use and seek a second implant. STUDY DESIGN Retrospective case review, within-subject comparison. SETTING Tertiary referral center. PATIENTS Thirty-one pediatric ( less then 18 yr) bimodal CI users who underwent sequential bilateral CI. INTERVENTIONS Sequential bilateral CI. MAIN OUTCOME MEASURES Parental and/or recipient's reasons for discontinuing their hearing aid and pursuing a second implant, device usage from datalogs, speech understanding in the bimodal and bilateral CI condition. RESULTS Parents/patients were motivated to pursue sequential bilateral CI based on their positive performance with CI1, the expectation of further improvement with a second CI, and the prospect of having a second independently functional ear. In the bimodal condition, mean word recognition score (WRS), sentence recognition in quiet (SIQ), and sentence recognition in noise (SIN) scores were 87.4, 97.3, and 92.9% respectively. At 1-year post-sequential bilateral CI, the mean WRS, SIQ, and SIN score were 92.7, 98.7, and 97.7%, respectively. The improvement in bilateral CI speech scores compared with bimodal scores was statistically significant for WRS (p = 0.015). A ceiling effect limited the ability to detect further meaningful differences on speech perception testing. CONCLUSIONS The bilateral CI condition demonstrates equivalent or slightly superior performance compared with the bimodal condition. Several non-speech benefits were elicited from parents as reasons for pursuing a second implant. Close monitoring of the residual acoustic hearing, inquiring about the perceived benefits provided by the HA, and early counseling regarding the potential for sequential bilateral CI are important aspects in determining if and when a second implant is indicated.OBJECTIVE We analyzed the long-term changes in speech perception ability of pediatric cochlear implants (CIs) to evaluate the effect of the age at the time of surgery. STUDY DESIGN Retrospective. SETTING Tertiary care academic center. PATIENTS One hundred fourteen prelingually deaf children with CI use duration >10 years. MAIN OUTCOME MEASURES Categories of auditory performance (CAP) scores and monosyllabic word recognition scores using the Asan-Samsung Korean word list (ASK-WRS) and a conventional word list (KS-WRS) were the main outcomes. Outcomes were compared according to the age at surgery (group I, 1-2 yr; II, 2.1-3 yr; III, 3.1-7 yr; IV, 7.1-13 yr). RESULTS CAP scores reached plateaus at 2.6 to 3.3 years post-CI; groups I to III showed better scores than group IV. The maximum CAP score was obtained in all children of groups I to III and in 65% of group IV. ASK-WRSs reached plateaus at 3.2 to 4.8 years post-CI. Younger patients at CI operation showed better ASK-WRSs (97, 93, 90, and 54% in groups I-IV, respectively), but the differences were not significant (I versus II and II versus III). Ceiling effect (perfect score) was observed in early groups (67, 44, 30, and 0% in groups I-IV). KS-WRSs, which is a challenging test, reached plateaus at 7.2 to 8.4 years postsurgery with no ceiling effect. Early implantees showed significantly better scores (88, 82, 73, and 46% in groups I-IV). CONCLUSIONS Speech perception ability after CI showed audiological age-specific improvement evaluated by various test methods. The most challenging test demonstrated long-term performance differences by the age at CI operation.