Background Aspirin-exacerbated respiratory disease (AERD), also known as Samter's triad or aspirin (ASA)-intolerant asthma, affects 7% of asthmatics and has a higher prevalence in those with chronic rhinosinusitis and concomitant nasal polyposis. ASA desensitization with daily ASA therapy is a uniquely beneficial treatment for this disease entity and has been shown to have a significant impact on symptom scores, polyp disease, and need for systemic corticosteroids. However, no long-term studies have demonstrated whether or not ASA therapy remains safe and beneficial for these patients beyond 5-10 years. Objective This study was designed to determine the clinical course of AERD patients desensitized between 1995 and 2010. Methods A 20-question survey was distributed to patients who successfully completed ASA desensitization between January 1995 and April 2010. The questions were designed to assess ASA safety and longitudinal effects of ASA therapy in AERD. Results Of the 285 patients contacted, 92 (32%) completed the questionnaire. Average length of follow-up was 15 years. Of survey responders, 35 patients had discontinued ASA therapy. Although adverse reactions occurred, many also discontinued due to lack of efficacy or need for surgery. For those remaining on ASA (62%), significant improvement in sense of smell, asthma, sinus, and allergic rhinitis scores were noted ( P ≤ .001). The majority of ASA patients (68%) had a positive response to treatment and did not require further sinus surgery. However, ASA therapy did not delay the time to next sinus/polyp surgery ( P = .27) or reduce total number of sinus surgeries ( P = .56) compared to those who stopped treatment. Nearly 85% of AERD patients on ASA therapy found it to be helpful in improving airway disease and quality of life. Conclusion Aspirin desensitization followed by daily maintenance ASA therapy appears to be safe and effective even after 10+ years of continuous use.
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http://dx.doi.org/10.1177/1945892418770260 | DOI Listing |
HPB (Oxford)
December 2024
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Electronic address:
Background: We sought to define textbook outcome in liver surgery (TOLS) for intrahepatic cholangiocarcinoma (ICC) by considering the implications of perioperative outcomes on overall survival (OS).
Methods: Using a multi-institutional database, TOLS for ICC was defined by employing novel machine learning (ML) models to identify perioperative factors most strongly predictive of OS ≥ 12 months. Subsequently, clinicopathologic factors associated with achieving TOLS were investigated.
World J Urol
January 2025
Department of Urology, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Purpose: The objective of this study was to evaluate the perioperative outcomes and complications associated with the use of acetylsalicylic acid (ASA) in deceased donor kidney transplantation (KTX), with a particular focus on bleeding events.
Methods: We retrospectively analyzed 157 kidney transplant recipients (KTRs) who underwent KTX at Charité Berlin, Department for Urology, between February 2014 and December 2017. Patients were divided into two groups: patients with ASA in their preoperative medication (Group A, n = 59) and patients without ASA use (Group B, n = 98).
Anesthesiology
January 2025
Fluid Therapy and Hemodynamic Monitoring, Spanish Society of Anesthesia and Critical Care (SEDAR), Madrid, Spain.
Background: Postoperative acute kidney injury (AKI) after major abdominal surgery leads to poor outcomes. The Hypotension Prediction Index (HPI) may aid in managing intraoperative hemodynamic instability. This study assessed if HPI-guided therapy reduces moderate-to-severe AKI incidence in moderate-to-high-risk elective abdominal surgery patients.
View Article and Find Full Text PDFNeurol Res Pract
January 2025
Goethe University Frankfurt, University Hospital, Department of Neurology, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
Background: Advances in secondary stroke prevention, including direct oral anticoagulants (DOACs), dual antiplatelet therapies (DAPT), and cardiovascular risk management, have changed costs over the past decade. This study aimed to evaluate annual treatment costs and trends in drug-based secondary prophylaxis after ischemic strokes.
Methods: Annual treatment costs were evaluated using the net costs per defined daily dosage (DDD) of discharge medications for ischemic stroke patients treated in 2020 at the University Hospital Frankfurt, Germany.
Mymensingh Med J
January 2025
Dr Md Khairul Kabir Khan, Junior Consultant, Department of Anaesthesiology and Intensive Care Unit, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
Different additives have been used to improve the duration and quality of analgesia of the local anaesthetic used in the single-dose caudal block technique, such as opioids, epinephrine, clonidine, neostigmine, etc. Dexmedetomidine is a potent and a highly selective α2-adrenergic agonist having a sympatholytic, sedative, and analgesic effect and has been described as a safe and effective additive in many anaesthetic and analgesic techniques. Another agent is Fentanyl, a lipophilic opioid, is added frequently to local anaesthetics which least likely to cause respiratory depression when given extradurally, because of its high lipid solubility.
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