Subject(s)
Humans , Male , Female , Chronic Pain , Terminology as Topic , Primary Health Care , Pain Management , Nociception , Central Nervous System SensitizationABSTRACT
The objective of this letter to the editor is to contextualize the concept of "nociplastic pain" in functional digestive disorders, especially in irritable bowel syndrome (IBS); and try to differentiate it from the term central sensitization, increasingly used in the literature, and with notable relevance in the pathophysiology of IBS.
Subject(s)
Neuralgia , Humans , Lacosamide/therapeutic use , Neuralgia/drug therapy , Analgesics , Double-Blind Method , PhenotypeSubject(s)
Humans , Stroke Volume , Heart Failure/drug therapy , Primary Health Care , Mortality , SpainSubject(s)
Heart Failure , Ventricular Dysfunction, Left , Humans , Stroke Volume , Heart Failure/drug therapySubject(s)
Humans , Male , Aged, 80 and over , Colonoscopy/methods , Propofol/adverse effects , Hypnotics and Sedatives/adverse effects , Urinalysis , ColorABSTRACT
Propofol (2,6-diisopropylphenol) is the most widely used drug for endoscopic procedures under deep sedation. We present the clinical case of an 83-year-old man who underwent a colonoscopy under sedation with propofol, observing a green discolouration of the urine during the procedure.
Subject(s)
Anesthesia , Deep Sedation , Propofol , Male , Humans , Aged, 80 and over , Propofol/adverse effects , Colonoscopy/methods , Conscious Sedation/methods , Deep Sedation/adverse effects , Deep Sedation/methods , Hypnotics and Sedatives/adverse effectsSubject(s)
Chronic Pain , Chronic Pain/psychology , Chronic Pain/therapy , Humans , Models, TheoreticalABSTRACT
INTRODUCTION: Combination therapy with an alpha blocker (AB) plus an antimuscarinic (AM) is recommended for men with moderate-to-severe mixed lower urinary tract symptoms (LUTS) when monotherapy is not effective in relieving storage symptoms. This study compared treatment persistence and adherence with an AB plus AM fixed-dose combination (FDC) vs an AB plus AM free-dose combination in men with LUTS in Spain. METHODS: Retrospective study using the Spanish IQVIA Cegedim Electronic Medical Records database. Men prescribed AB plus AM combination therapy were included in an FDC or free-dose combination cohort based on their index treatment. Treatment persistence was the time from index date to first discontinuation of ≥1 of the two index drugs over 12 months. Adherence was measured using the fixed medication possession ratio (MPR). RESULTS: Of 3114 patients identified, 999 were included (FDC, n = 790; free-dose combination, n = 209). Median (95% CI) persistence was longer in the FDC (125 [109-151] days) than in the free-dose combination (31 [31-36] days) cohort (hazard ratio [HR], 2.9; 95% CI, 2.4-3.4; P < .0001). The 12-month persistence rates were 31.1% (FDC cohort) and 8.9% (free-dose cohort). The mean (SD) fixed MPR was higher in the FDC cohort (48.8 [37.2]) compared with the free-dose cohort (23.1 [28.4]); more patients in the FDC cohort (34.2%) than in the free-dose cohort (10.0%) were adherent (MPR ≥ 80%). The probability of treatment persistence and adherence increased with age (>80 vs <65 years, persistence HR, 0.7 [95% CI, 0.5-0.9]; MPR difference, 12.5), polypharmacy (persistence HR, 0.7 [95% CI, 0.6-0.9]; MPR difference, 10.7) and previous use of AB (persistence HR, 0.8 [95% CI, 0.7-1.0]; MPR difference, 5.7) or AB/AM combinations (persistence HR, 0.7 [95% CI, 0.5-0.9]; MPR difference, 11.1). CONCLUSIONS: Treatment with an AB/AM FDC is associated with better persistence and adherence vs a free-dose combination in men with LUTS in Spain.
Subject(s)
Lower Urinary Tract Symptoms , Muscarinic Antagonists , Aged , Drug Therapy, Combination , Humans , Lower Urinary Tract Symptoms/drug therapy , Male , Medication Adherence , Muscarinic Antagonists/therapeutic use , Retrospective Studies , SpainSubject(s)
Urinary Bladder Neck Obstruction , Animals , Disease Models, Animal , Humans , UrodynamicsABSTRACT
No disponible