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Analgesic effect of paracetamol combined with low- dose morphine versus morphine alone on patients with biliary colic： a double blind, randomized controlled trial

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World Journal of Emergency Medicine 2016年第1期7卷 25-29页

作者： Mohammad Reza Farnia rasoul babaei Farzaneh Shirani Mehdi Momeni Majid Hajimaghsoudi Elnaz Vahidi Morteza Saeedi Emergency Medicine Department Imam Reza Hospital Kermanshah University of Medical Sciences Kermanshah Iran Emergency Medicine Department Shariati Hospital Tehran University of Medical Sciences Tehran Iran Emergency Medicine Research Center Emergency Medicine Department Shariati Hospital Tehran University of Medical Sciences Tehran Iran Emergency Medicine Department Shahid Dr Rahnemoon Hospital Shahid Sadoughi University of Medical Sciences Yazd Iran

BACKGROUND:Numerous drugs have been proposed to alleviate pain in patients with biliary colic,especially opioids,but still there is a tendency to use less narcotics because of their side effects and the unwillingness of some patients.The present study aimed to compare the analgesic effect of paracetamol combined with low-dose morphine versus morphine alone in patients with biliary colic.METHODS:A randomized double-blind controlled trial was performed in 98 patients with biliary colic,recruited from two emergency departments from August 2012 to August 2013.Eleven patients were excluded and the remaining were randomized into two groups:group A received 0.05mg/kg morphine+1 000 mg paracetamol in 100 m L normal saline and group B received 0.1 mg/kg morphine+normal saline(100 m L)as placebo.Pain scores were recorded using visual analogue scale(VAS)at baseline and 15 and 30 minutes after drug administration.Adverse effects and the need for rescue medication(0.75 g/kg intravenous fentanyl)were also reported within 60 minutes of drug administration.RESULTS:Before the infusion,the mean±SD VAS scores were 8.73±1.57 in group A and8.53±1.99 in group B.At 15 minutes after drug administration,the mean±SD VAS scores were2.16±1.90 in group A vs.2.51±1.86 in group B;mean difference was–0.35,and 95%CI–1.15 to 0.45(P=0.38).At 30 minutes the mean±SD VAS scores were 1.66±1.59 in group A vs.2.14±1.79 in group B;mean difference was–0.48,and 95%CI–1.20 to 0.24(P=0.19).The mean pain scores in the two groups at 15 and 30 minutes demonstrated no significant difference.CONCLUSION:Paracetamol combined with low-dose morphine may be effective for pain management in patients with biliary colic.

关键词： Biliary colic Morphine Paracetamol Visual analogue scale

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Simplified microsatellite instability detection protocol provides equivalent sensitivity to robust detection strategies in Lynch syndrome patients

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Cancer Biology & Medicine 2017年第2期14卷 142-150页

作者： Hadi babaei Mehrdad Zeinalian Mohammad Hassan Emami Mortaza Hashemzadeh Najmeh Farahani rasoul Salehi Department of Genetics and Molecular Biology School of MedicineIsfahan University of Medical Sciences Clinic of Gastrointestinal Diseases Poursina Hakim Research CenterIsfahan University of Medical Sciences Cellular and Molecular Research Center Shahrekord University of Medical Sciences

Objective:Germline mutations in mismatch repair(MMR)genes cause Lynch syndrome(LS).LS is an inherited disease,and an important consequence of MMR deficiency is microsatellite instability(MSI)phenotype.MSI phenotype influences the efficacy of5 fluorouracil(5-FU)chemotherapy.Reproducible,cost effective,and easy to perform laboratory tests are required to include MSI detection in routine laboratory practice.Evaluation of CAT25 as monomorphic short tandem repeat sequence enables CAT25 to be an efficient screening tool among hereditary nonpolyposis colorectal cancer(HNPCC)patients compared with other methods used currently.Methods:Based on Amsterdam II criteria,31 patients in 31 families were shortlisted from a total number of 1,659 colorectal cancer patients.MSI status was examined in these patients using CAT25 and a commercially available Promega MSI five-markerbased detection system as well as immunohistochemical(IHC)staining of four important MMR proteins.Patients were scored as high microsatellite instable(MSI-H),low(MSI-L),or stable(MSS).MSI status determined by CAT25 single mononucleotide marker was compared with that of five mononucleotide markers,Promega commercial kit,and IHC method.Results:MMR protein deficiency was observed on 7/31 probands using IHC methodology and 6/31 categorized as MSI-H using commercial kit or CAT25 single marker.The sensitivity and specificity of the CAT25 single marker were the same as those detected by five-marker Promega commercial kit in our patients.Conclusions:Based on our results,the performance of the CAT25 single mononucleotide marker for MSI status determination in our HNPCC patients is the same as that of the five-marker-based commercial kit.

关键词：微卫星不稳定性稳定性检测检测策略敏感性综合征患者免疫组化方法短串联重复序列

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