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

Photodynamic Therapy and Extracorporeal Photochemotherapy in Dermatology

Extracorporeal photochemotherapy or photopheresis is an extracorporeal ultraviolet and a photosensitizer (8-MOP) exposure of plasma. It is reported to be effective for several dermatoses such as cutaneous T cell lymphoma, autoimmune diseases and graft versus host disease. Photodynamic therapy involves the use of a photosensitizer in combination with visible light which is the correct wavelight for the photosensitizer. It has become an alternative treatment method for dermatooncologic conditions like actinic keratosis and basal cell carcinoma. In addition to these dermatoses, it is used for many non-neoplastic dermatoses such as acne, localized scleroderma and in some aesthetic indications

Psoriasis disability index: The role of sociodemographic and clinical variables

Background and Design: A variety of studies have demonstrated that psoriasis can affect psychological, social and physical functions. The purpose of this study was to determine the impact of the sociodemographic and clinical characteristics on Psoriasis Disability Index (PDI), which is a psoriasis-specific health-related quality of life instrument

Comparison of weekly low-dose and high-dose incremental protocols of narrow band ultraviolet B therapy for psoriasis

Background and Design: Considering the probable long-term side-effects of narrowband UVB (NB-UVB) therapy, various studies have been conducted to provide more effective and reliable protocols by applying the different initial doses, numbers of sessions or dose increments. The aim of this study was to compare the clinical effectiveness of weekly low-dose increments and weekly high-dose increments of NB-UVB therapy in psoriasis

Comparison of weekly low-dose and high-dose incremental protocols of narrow band ultraviolet B therapy for psoriasis

Background and Design: Considering the probable long-term side-effects of narrowband UVB (NB-UVB) therapy, various studies have been conducted to provide more effective and reliable protocols by applying the different initial doses, numbers of sessions or dose increments. The aim of this study was to compare the clinical effectiveness of weekly low-dose increments and weekly high-dose increments of NB-UVB therapy in psoriasis

Effectiveness of Online Education in Teaching Breast Self-Examination

WOS: 000336834500048PubMed ID: 24815475Background: This research evaluated the effectiveness of an online education model in teaching breast self-examination to university staff and students. Materials and Methods: 1,679 women participated in a breast self-examination online training program. Breast self-examination knowledge evaluation forms developed by Maurer (1997) were used in the research and were evaluated on a 100 point scale. Paired t-test and McNemar's Test statistics were employed. Results: The participants scored an average of 46.5 (14.0%) on knowledge on breast self-examination before training, but 77.4 (11.0%) one month after education and 76.7 (9.52%) after six months. There was a clear significant difference between these knowledge levels (p<0.05). Similarly, while the rate for systematic practice of breast self-examination among women was 30.8% before training it increased to 47.8% afterwards. Again the difference was significant (p<0.05). Conclusions: Online education is an effective method for teaching breast self-examination to women

The Effect of Glomerular C3 Deposition on Renal Outcome in Patients With Membranous Nephropathy: Data of The Tsn-Gold Study

60th ERA Congress -- JUN 15-18, 2023 -- Milan, ITALY[No abstract available

An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation

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