4 research outputs found
Evaluation of markers to predict tumor response to breast cancer neoadjuvant chemotherapy
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SCREENING OF DESI AND KABULI CHICKPEA (CICER ARIETINUM L.) ENTRIES AGAINST ALTERNARIA BLIGHT
No full text*Author for correspondence Alternaria blight caused by Alternaria sp. became serious threat for early sown chickpea crop in and around Karnataka. In order to identify resistance sources for these diseases screening was carried out during 2011 in ZARS, GKVK, Bengaluru. Hundred and thirty nine chickpea entries including ninety six desi and fouty three kabuli chickpea entries were screened against the disease among that four entries viz., PBG 5, H08-93 (desi), GLK 26167, JGK 13(R) (kabuli) entries were found to be resistant, six entries viz., Phule G 09103 (desi), GNG 1888, CSJK 6(R),Phule G 09316, Kripa (Phule G 0517) and BG 3012(R) (kabuli) entries were found to be moderately resistant and it was observed that out of ninety six desi chickpea entries eighty four about 87.5 % of the entries were found to be highly susceptible compared to twenty nine about 67.4 % entries of kabuli chickpea were found to be highly susceptible out of fourty three entries against Alternaria blight
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
No full textBackground: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures. Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge. Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to sideeffects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and lowand middle-income countries, patient-reported outcomes did not. Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
Predicting opioid consumption after surgical discharge: a multinational derivation and validation study using a foundation model
No full textOpioids are frequently overprescribed after surgery. We applied a tabular foundation model to predict the risk of post-discharge opioid consumption. The model was trained and internally validated on an 80:20 training/test split of the ‘Opioid PrEscRiptions and usage After Surgery’ (ACTRN12621001451897p) study cohort, including adult patients undergoing general, orthopaedic, gynaecological and urological operations (n = 4267), with external validation in a distinct cohort of patients discharged after general surgical procedures (n = 826). The area under the receiver operator curve was 0.84 (95% confidence interval [CI] 0.81–0.88) at internal testing and 0.77 (95% CI 0.74–0.80) at external validation. Brier scores were 0.13 (95% CI 0.12–0.14) and 0.19 (95% CI 0.17–0.2). Patients with a <50% predicted risk of opioid consumption consumed a median of 0 oral morphine equivalents in the first week after surgery. Applying this model would reduce opioid prescriptions by 4.5% globally, and counterfactual modelling suggests without increasing time in severe pain (−4.3%, 95% CI −17.7 to 8.6)
