Recent advances: rheumatology

No abstract available

Recent advances: rheumatology

No abstract available

Non-steroidal anti-inflammatory drugs—changes in prescribing may be warranted

No abstract available

Risk of acute myocardial infarction with nonselective non-steroidal anti-inflammatory drugs: a meta-analysis

The use of cyclo-oxygenase 2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with increased risk of acute myocardial infarction (AMI). The association between the risks of AMI with nonselective NSAIDs is less clear. We reviewed the published evidence and assessed the risk of AMI with nonselective NSAIDs. We performed a meta-analysis of all studies containing data from population databases that compared the risk of AMI in NSAID users with that in non-users or remote NSAID users. The primary outcome was objectively confirmed AMI. Fourteen studies met predefined criteria for inclusion in the meta-analysis. Nonselective NSAIDs as a class was associated with increased AMI risk (relative AMI risk 1.19, 95% confidence interval [CI] 1.08 to 1.31). Similar findings were found with diclofenac (relative AMI risk 1.38, 95% CI 1.22–1.57) and ibuprofen (relative AMI risk 1.11, 95% CI 1.06 to 1.17). However, this effect was not observed with naproxen (relative AMI risk 0.99, 95% CI 0.88–1.11). In conclusion, based on current evidence, there is a general direction of effect, which suggests that at least some nonselective NSAIDs increase AMI risk. Analysis based on the limited data available for individual NSAIDs, including diclofenac and ibuprofen, supported this finding; however, this was not the case for naproxen. Nonselective NSAIDs are frequently prescribed, and so further investigation into the risk of AMI is warranted because the potential for harm can be substantial

On Simultaneous Information and Energy Transmission through Quantum Channels

The optimal rate at which information can be sent through a quantum channel when the transmitted signal must simultaneously carry some minimum amount of energy is characterized. To do so, we introduce the quantum-classical analogue of the capacity-power function and generalize results in classical information theory for transmitting classical information through noisy channels. We show that the capacity-power function for a quantum channel, for both unassisted and private protocol, is concave and also prove additivity for unentangled and uncorrelated ensembles of input signals. This implies we do not need regularized formulas for calculation. We numerically demonstrate these properties for some standard channel models. We obtain analytical expressions for the capacity-power function for the case of noiseless channels using properties of random quantum states and concentration phenomenon in large Hilbert spaces.Comment: 13 pages, 16 figure

Quantum ergodicity and entanglement in kicked coupled-tops

We study the dynamical generation of entanglement as a signature of chaos in a system of periodically kicked coupled-tops, where chaos and entanglement arise from the same physical mechanism. The long-time averaged entanglement as a function of the position of an initially localized wave packet very closely correlates with the classical phase space surface of section -- it is nearly uniform in the chaotic sea, and reproduces the detailed structure of the regular islands. The uniform value in the chaotic sea is explained by the random state conjecture. As classically chaotic dynamics take localized distributions in phase space to random distributions, quantized versions take localized coherent states to pseudo-random states in Hilbert space. Such random states are highly entangled, with an average value near that of the maximally entangled state. For a map with global chaos, we derive that value based on new analytic results for the typical entanglement in a subspace defined by the symmetries of the system. For a mixed phase space, we use the Percival conjecture to identify a "chaotic subspace" of the Hilbert space. The typical entanglement, averaged over the unitarily invariant Haar measure in this subspace, agrees with the long-time averaged entanglement for initial states in the chaotic sea. In all cases the dynamically generated entanglement is predicted by a unitary ensemble of random states, even though the system is time-reversal invariant, and the Floquet operator is a member of the circular orthogonal ensemble.Comment: 12 pages with 8 figure

The pain of low status: the relationship between subjective socio-economic status and analgesic prescriptions in a Scottish community sample

There is a strong positive relationship between objective measures of socioeconomic status (OSS) and general health. However, there is an increasing interest in the relationship between health and subjective socioeconomic status (SSS), which describes one’s perceived rank in relation to the rest of society, based on factors such as income, occupation, and education. While the relationship between SSS and general health is well2established, the relationship between SSS and pain has received little attention. Gathering both self2report questionnaire data and General Practitioner medical data from a large representative community sample in Scotland between 2012 and 2013 ( N = 1824), we investigated the relationship between SSS and prescriptions for analgesic drugs. We found that higher levels of SSS significantly predicted lower odds of participants having been prescribed at least one analgesic drug in the previous six months. We obtained this result even after controlling for OSS2related variables (education, occupational status, and geographical location) and demographic variables (age and gender). This suggests that, just like the relationship between SSS and general health, SSS has important effects on pain that go beyond the influence of OSS

Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options

This study aimed to establish the optimal diagnostic and treatment algorithm for the management of gastric fistula in the chest (GFIC) after sleeve gastrectomy (SG) through a systematic review of published cases. A multi-database search was performed, which produced 1182 results, of which 26 studies were included in this systematic review. The initial presentation included subphrenic collections, leaks, or (recurrent) pneumonia with associated symptoms such as persistent cough, fever, and/or dyspnea. Computed tomography (CT) scan in combination with either upper gastrointestinal (UGI) series or an esophagogastroduodenoscopy (EGD) was used to adequately diagnose the fistulas. Initial treatment was either with clips and/or clips and stents that were placed endoscopically. When unsuccessful in the majority of the cases, the surgical treatment consisted of total gastrectomy and Roux-en-Y esophagojejunostomy in a laparoscopic or open fashion