Background: Characterizing the impacts of postoperative opioid use on total knee arthroplasty (TKA) patients may help optimize the pain management after TKA. The aim of the study is to examine the prevalence and risk factors for opioid use with an enhanced-recovery programme after primary TKA.
Methods: We identified 361 patients undergoing TKA, and separated those on the basis of whether to receive opioid use after surgery. Themultivariate logistic regression model was used to identify independent risk factors for opioid use after primary TKA. Length of stay (LOS) and postoperative complications were also recorded and compared.
Results: The prevalence of opioid use after primary TKA was 23.0%. The significant risk factor was the longer operative time (OR [odds ratio] = 1.017, 95% CI [confidence interval] = 1.001 to 1.032, p = 0.034) and the protective factor was the utilization of tranexamic acid(OR= 0.355, 95% CI = 0.161 to 0.780, p = 0.010). In addition, the LOS was longer in opioid group (p < 0.05).
Conclusion: Considering the adverse health effects of opioid use, strategies need to be developed to prevent persistent opioid use after TKA. Reducing operative time and the application of tranexamic acid could lower the risk of opioid use with an enhanced-recovery programme after primary TKA.
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http://dx.doi.org/10.1186/s12891-021-04937-8 | DOI Listing |
Endocrinol Diabetes Metab
January 2025
Department of Endocrinology and Metabolism, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Objective: This study investigates the relationship between the albumin-to-creatinine ratio and diabetic retinopathy (DR) in US adults using NHANES data from 2009 to 2016. This study assesses the predictive efficacy of the urinary serum albumin-to-creatinine ratio (UACR/SACR Ratio) against traditional biomarkers such as the serum albumin-to-creatinine ratio (SACR) and urinary albumin-to-creatinine ratio (UACR) for evaluating DR risk. Additionally, the study explores the potential of these biomarkers, both individually and in combination with HbA1c, for early detection and risk stratification of DR.
View Article and Find Full Text PDFJ Crohns Colitis
January 2025
Servei d'Aparell Digestiu, Hospital Universitari Germans Trias i Pujol (Badalona, Catalonia, Spain).
Background And Aims: Inflammatory bowel disease (IBD) develops in genetically susceptible individuals exposed to certain environmental factors, of which only a few have been established. We aimed to assess whether bariatric surgery (BS) and severe obesity are associated with an increased risk of developing IBD.
Methods: Adults diagnosed with obesity or severe obesity between 2005 and 2020 were identified from the Catalan Health Surveillance System; those diagnosed with IBD prior to the diagnosis of obesity or severe obesity were excluded.
Jpn J Ophthalmol
January 2025
Department of Visual Science and Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Purpose: To review hospitalized patients with Acute Retinal Necrosis (ARN) and investigate factors associated with subsequent retinal detachment (RD).
Study Design: Retrospective.
Methods: The study included 40 patients (42 eyes), categorized into non-RD (23 eyes) and RD (19 eyes) groups.
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
View Article and Find Full Text PDFClin Rheumatol
January 2025
Department of Public Health, University of Murcia, Campus de Ciencias de la Salud, Murcia, 30120, Spain.
Introduction: Therapeutic drug monitoring (TDM) in inflammatory rheumatic diseases (RMDs) is gaining interest. However, there are unresolved questions about the best practices for implementing TDM effectively in clinical settings.
Objective: The primary objective of this study was to evaluate whether early TDM of adalimumab predicts drug survival at 52 weeks in patients with RMDs.
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