Paired data for self-report and electronic monitoring were analysed. Measurement of agreement was by Bland-Altman-like plots by visit with calculation of limits of agreement.
Results: For single and combination ICS/LABA therapy, self-report consistently overestimated actual inhaler use assessed by electronic monitoring by a mean of 2.2-8.4 inhalations over a 1-week period, with limits of agreement ranging from +/- 15.8 to 25.6 inhalations. Participants who underused
their inhalers tended to overreport their use, while those who overused tended to underreport their medication find more use. The greater the degree of underuse, the greater the magnitude of overreport, and likewise, the greater the degree of overuse, the greater
the magnitude of underreport.
Conclusions: Self-report is inaccurate in measuring actual use of inhaled asthma treatment with patients who underuse their maintenance therapy overreporting their use and those who overuse their therapy underreporting their use.”
“Objective.
We report a case of acute lower extremity compartment syndrome that was diagnosed despite continuous regional analgesia with 0.2% ropivacaine via femoral and sciatic nerve catheters.
Setting.
Academic tertiary care center.
Study Design.
Report of a clinical case.
Summary.
A 15-year-old boy with adolescent Blount’s disease underwent elective distal femur and proximal tibia osteotomy www.selleckchem.com/products/ABT-263.html with external fixation and stabilization of his right leg. The patient’s anesthetic and analgesic management included general anesthesia with adjunctive regional anesthesia via BIX 01294 clinical trial continuous femoral and sciatic
nerve blocks with 0.2% ropivacaine-each block initially infused at 10 mL per hour. On the first postoperative day, the patient reported no pain (0/10 on the visual analog scale, where 0 is no pain and 10 is the worst pain imaginable). However, on the second postoperative day, the patient reported severe pain despite effective blocks and oral opioid analgesic modalities. Compartment syndrome was diagnosed and treated with decompressive fasciotomy; tissue loss resulted.
Conclusion.
Despite concerns of masking pain that may be secondary to compartment syndrome, this case demonstrates that compartment syndrome can be diagnosed in the presence of effective regional anesthesia. Careful clinical evaluation coupled with a high index of suspicion is essential in the timely diagnosis and effective treatment of compartment syndrome.”
“Vocal cord dysfunction (VCD) is characterized by paradoxical inspiratory abduction of the vocal cords. Gastro-oesophageal reflux disease (GORD) is a known trigger. We studied 77 patients referred to a tertiary VCD clinic. VCD was diagnosed in 62, of which 83.9% had proven GORD. Following 8 weeks of acid suppression, 24.2% reported improvement in the severity and frequency of VCD attacks.