23 Aug, 12 | by BMJ Group
Articles of interest in other scholarly journals.
Colli A, Conte D, Valle SD, Sciola V, Fraquelli M.
This systematic review with meta-analysis assessed the analgesic benefits and reduction of complications, as well as the potential harms from randomised clinical trials (RCTs) evaluating non-steroid anti-inflammatory drugs (NSAIDs) in biliary colic. Eleven RCTs with over 1000 subjects were included. In comparison with placebo, patients on NSAIDs were more likely to have complete pain relief and a lower rate of complications. In comparison with other drugs, NSAIDs were more efficacious in controlling pain than spasmolytics but there was no difference between NSAIDs and opioids. The authors conclude that NSAIDs are the first-line analgesic for patients with biliary colic as they control pain with the same efficacy of opioids and also reduce complications, but acknowledge the limitation of the lack of high-quality evidence with heterogeneity in the studies.
Pantilat SZ, O’Riordan DL, Dibble SL, Landefeld CS.
In a prospective cohort study the prevalence, severity, burden and predictors of common symptoms during hospitalisation and 2 weeks after discharge in patients over 65 with cancer, heart failure and chronic obstructive pulmonary disease were determined. On admission, 54% reported moderate or severe pain, 53% dyspnoea and 62% anxiety. 64% had 2 or more symptoms at a moderate or severe intensity. The prevalence of moderate or severe symptoms decreased by around 50% during admission and at the 2 week follow-up. There was no association between diagnosis and symptom severity at or during admission but at 2-weeks more patients with chronic obstructive pulmonary disease had moderate or severe pain, dyspnoea and symptom burden compared to those with cancer or heart failure.
Vandyk AD, Harrison MB, Macartney G, Ross-White A, Stacey D.
This systematic review explored symptoms caused by cancer and its treatment at presentation to the emergency department. It included six prospective and 12 retrospective studies. 28 symptoms were reported, the most common being febrile neutropenia, infection, pain, fever, and dyspnoea, although symptoms definitions were inconsistent. 16 studies reported admission rates and showed that on average 58 % of patients were admitted to hospital. 11 studies reported mortality rates and showed an average of 13 % (in multi-symptom studies) and 20 % (in targeted symptoms studies) of emergency department presentations resulted in death.