Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Determination of Apigenin in Cosmetics Containing Chamomile by High-Performance Liquid Chromatography with Ultraviolet Detection (HPLC-UV)

© 2022 Taylor & Francis Group, LLC.A simple, rapid, and precise high performance liquid chromatography (HPLC) method was developed to determine the flavonoid apigenin in cosmetic products containing chamomile extracts. A C18 column was used as stationary phase and 70:30 ethanol:water was used as mobile phase with a 1 mL/min flow rate and isocratic elution. The temperature was stabilized at 25 °C during the separation. The injection volume was 50 μL. The apigenin peak was eluted at 4.15 ± 0.4 min. The method was validated according to International Conference on Harmonisation (ICH) criteria in terms of linearity, limit of detection, limit of quantitation, selectivity, sensitivity, robustness, accuracy, and precision. The limits of detection and quantitation were 0.060 and 0.2 μg/mL respectively. The linear range was from 0.2 to 20 μg/mL. The relative standard deviation values for intraday and interday analyses were less than 1.64%. The developed procedure was applied to the analysis of various cosmetic products. It is expected that the method is suitable for routine analysis, quality control and standardization of cosmetic products for apigenin

The cytotoxic effect of endemic Centaurea fenzlii Reichardt on colon cancer cell lines

International Congress on Natural Products Research on Global Change, Natural Products and Human Health/8th Joint Meeting of AFERP, ASP, GA, PSE and SIF -- JUL 28-AUG 01, 2012 -- New York, NYYIRTICI, Umit/0000-0002-0142-6105; Icgen, Bulent/0000-0001-8114-4230;WOS: 000307042801063…Amer Soc Pharmacognosy (ASP), Soc Med Plant & Nat Prod Res (GA), Italian Soc Phytochem (SIF), Phytochem Soc Europe (PSE), French Speaking Soc Pharmacognosy (AFERP

Rich complex behaviour of self-assembled nanoparticles far from equilibrium

A profoundly fundamental question at the interface between physics and biology remains open: what are the minimum requirements for emergence of complex behaviour from non-living systems? Here, we address this question and report complex behaviour of tens to thousands of colloidal nanoparticles in a system designed to be as plain as possible: the system is driven far from equilibrium by ultrafast laser pulses that create spatiotemporal temperature gradients, inducing Marangoni flow that drags particles towards aggregation; strong Brownian motion, used as source of fluctuations, opposes aggregation. Nonlinear feedback mechanisms naturally arise between flow, aggregate and Brownian motion, allowing fast external control with minimal intervention. Consequently, complex behaviour, analogous to those seen in living organisms, emerges, whereby aggregates can self-sustain, self-regulate, self-replicate, self-heal and can be transferred from one location to another, all within seconds. Aggregates can comprise only one pattern or bifurcated patterns can coexist, compete, endure or perish

Validity and reliability of the Turkish version of DSM-5 level 2 anxiety scale (Child form for 11-17 years and parent form for 6-17 years)

Introduction: This study aimed to assess the validity and reliability of the Turkish Version of DSM-5 Level 2 Anxiety Scale’s child and parent forms. Methods: The scale was constructed by carrying out the translation and back translation of DSM-5 Level 2 Anxiety Scale. The study group consisted of a community and clinical sample. The scale was applied to 148 parents and 189 adolescents that represented the clinical and community sample. During the assessment process, Screen for Childhood Anxiety Related Emotional Disorders and Strengths and Difficulties Questionnaire-Parent Form were also used. Results: Reliability analyses indicated a high internal consistency regarding Level 2 Anxiety Scales, both for child and parent forms (0.915/0.933). In the meantime, it was shown that child form for Level 2 Anxiety Scale was significantly correlated with Screen for Childhood Anxiety Related Emotional Disorders (r=0.758, p<0.0001) while the parent form was significantly correlated with Strengths and Difficulties Questionnaire-Parent Form (r=0.717, p<0.0001). As for the content validity, one factor was obtained for both forms, and it was observed to be consistent with the original construct of the scale. Conclusion: It was concluded that Turkish version of DSM-5 Level 2 Anxiety Scale was a valid and reliable tool to be utilized both for clinical practice, and research purposes. © 2016 by Turkish Association of Neuropsychiatry