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, Los Angeles Los Angeles, CA Nancy Lane, M.D. Director and Distinguished Professor Center for Musculoskeletal Health and Department of Internal Medicine University of California at Davis, School of Medicine Sacramento, California Jasvinder Singh, M.D., M.P.H. Division of Rheumatology University of Alabama Birmingham, AL vii Long-Term DrugTherapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review Structured Abstract Objective. To summarize the effects of long-term (...) Long-Term DrugTherapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review Long-Term DrugTherapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review Comparative Effectiveness Review Number 218 RComparative Effectiveness Review Number 218 Long-Term DrugTherapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition Guidelines for the Provision and Assessment of Nutrition Sup... : Pediatric Critical Care Medicine 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were (...) Medicine, to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric (> 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were scanned for relevance. The PubMed/Medline search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search
, great emphasis was placed on appropriate patient selection. Currently in the United States, patients rarely remain hospitalized solely to complete a course of parenteral antimicrobial therapy. Except for some persons who inject drugs (PWID), most patients are eligible for some form of OPAT. The current focus is on identifying the appropriate setting for OPAT, that is, whether patients will receive their antimicrobials at home, in an infusion center, or in a SNF. The exact delivery model chosen (...) 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy Outpatient Antimicrobial ParenteralTherapy Search Search 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy Published : 13 November 2018 Anne H Norris, Nabin K Shrestha, Genève M Allison, Sara C Keller, Kavita P Bhavan, John J Zurlo, Adam L Hersh, Lisa A Gorski, John A Bosso, Mobeen H Rathore, Antonio Arrieta, Russell M Petrak, Akshay Shah
. Citation Minton J, Czoski Murray C, Meads D, Hess S, Vargas-Palacios A, Mitchell E, Wright J, Hulme C, Raynor D K, Gregson A, Stanley P, McLintock K, Vincent R & Twiddy M. The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy. Health Services and Delivery Research 2017; 5(6) Authors' objectives Outpatient parenteral antimicrobial therapy (OPAT (...) The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods
Delivery, setting and outcomes of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): a scoping review. There has been little detailed systematic consideration of the delivery, setting and outcomes of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT), although individual studies report that it is a safe and effective treatment.This scoping review aimed to examine what is known about the delivery, settings and outcomes of paediatric OPAT and to identify key knowledge (...) the inclusion criteria. Factors influencing delivery of OPAT were diverse and included child's condition, home environment, child-related factors, parental compliance, training and monitoring. There is little consensus as to what constitutes success of and adverse events in OPAT.Future studies need to clearly define and use success indicators and adverse events in order to provide evidence that paediatric OPAT is safe and effective.Consensus outcomes that include child and parent perspectives need
Preparation, characterization, and potential application of chitosan, chitosan derivatives, and chitosan metal nanoparticles in pharmaceuticaldrugdelivery Naturally occurring polymers, particularly of the polysaccharide type, have been used pharmaceutically for the delivery of a wide variety of therapeutic agents. Chitosan, the second abundant naturally occurring polysaccharide next to cellulose, is a biocompatible and biodegradable mucoadhesive polymer that has been extensively used (...) the pharmaceutical applications of these particles in drugdelivery. Moreover, the roles of chitosan derivatives and chitosan metal nanoparticles in drugdelivery have been illustrated.
An Overview of Chitosan Nanoparticles and Its Application in Non-ParenteralDrugDelivery The focus of this review is to provide an overview of the chitosan based nanoparticles for various non-parenteral applications and also to put a spotlight on current research including sustained release and mucoadhesive chitosan dosage forms. Chitosan is a biodegradable, biocompatible polymer regarded as safe for human dietary use and approved for wound dressing applications. Chitosan has been used (...) -based NP have various applications in non-parenteraldrugdelivery for the treatment of cancer, gastrointestinal diseases, pulmonary diseases, drugdelivery to the brain and ocular infections which will be exemplified in this review. Chitosan shows low toxicity both in vitro and some in vivo models. This review explores recent research on chitosan based NP for non-parenteraldrugdelivery, chitosan properties, modification, toxicity, pharmacokinetics and preclinical studies.
for intrathecal drugdelivery systems for patients with chronic non-malignant back pain BACKGROUND Cancer is the leading cause of death in Canada: it was associated with an estimated 76,600 deaths in 2014. 1 About two thirds of patients with incurable cancer experience pain. 2 At the end of life, about 10% to 30% of cancer patients receiving conventional pain therapies have pain that is refractory (difficult to manage) or persistent. 2 Currently available options include opioid rotation, parenteral infusions (...) , neuraxial analgesia, nerve blocks, and surgery. Refractory pain and concerns about side effects drive the search for alternative pain management options in cancer patients. Reliable estimates of the prevalence of refractory noncancer chronic pain are difficult to find. Options available to treat refractory pain include non-opioid analgesic medications, opioid analgesics, neuraxial analgesia, nerve blocks, and surgery, as well as multidisciplinary rehabilitation programs. 3 Intrathecal drugdelivery
DrugDelivery Aka: ParenteralDrugDelivery , Injectable DrugDelivery Route , Injectable Medication Route , Injectable Route of MedicationDelivery II. Types (SQ or SC) (IM) Intravascular Injection (IV) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "ParenteralDrugDelivery." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics (...) ParenteralDrugDeliveryParenteralDrugDelivery Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 ParenteralDrugDeliveryParenteral
Successful outpatient parenteral antibiotic therapydelivery via telemedicine. Most outpatient parenteral antimicrobial therapy (OPAT) services use a hospital-based model of care in which patients remain in proximity to large hospitals facilitating clinical review. We aimed to evaluate clinical outcomes and complication rates for patients living in geographically isolated locations managed by telemedicine-supported OPAT. Methods: This was a retrospective cohort study.Between 2011 and 2015, we (...) in 87% of patients and the unplanned, OPAT-related readmission rate was 8%. Nineteen percent and 10% of patients had drug-related and line-related adverse effects, respectively.Despite a complex case mix, our adverse event and readmission rates are similar to the published literature describing a non-telemedicine model to deliver OPAT. High rates of favourable clinical outcomes and likely cost benefits suggest that telemedicine-supported OPAT is an efficacious and safe substitute for inpatient care
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. This document represents the first collaboration between two organizations, American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine, to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended (...) route and timing of nutrient delivery is an area of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The role of supplemental parenteral nutrition has been highlighted, and a delayed approach appears to be beneficial. Immunonutrition cannot be currently recommended. Overall, the pediatric critical care population is heterogeneous, and a nuanced approach
Human Factors approaches to evaluating outpatient parenteral antimicrobial therapy services: A systematic review. The expansion in terms of available treatment options and models of care has led to a growing global momentum for outpatient antimicrobial therapy (OPAT) services. A systematic review was undertaken to explore Human Factors aspects relating to OPAT service delivery and to evaluate whether OPAT is amenable to description using the Systems Engineering Initiative for Patient Safety (...) (SEIPS 2.0) model.Following a preliminary search, a search string was applied to four databases, including Medline, Cumulative Index of Nursing and Allied Health Literature, International Pharmaceutical Abstracts and PsychINFO. Inclusion criteria ensured only articles published after the year 2000 and written in English were accepted. The methodological quality of studies was assessed by three reviewers. Narrative synthesis was performed to uncover the key interactions between work system entities
Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit. Critically ill people are at increased risk of malnutrition. Acute and chronic illness, trauma and inflammation induce stress-related catabolism, and drug-induced adverse effects may reduce appetite or increase nausea and vomiting. In addition, patient management in the intensive care unit (ICU) may also interrupt feeding routines. Methods to deliver (...) nutritional requirements include provision of enteral nutrition (EN), or parenteral nutrition (PN), or a combination of both (EN and PN). However, each method is problematic. This review aimed to determine the route of delivery that optimizes uptake of nutrition.To compare the effects of enteral versus parenteral methods of nutrition, and the effects of enteral versus a combination of enteral and parenteral methods of nutrition, among critically ill adults, in terms of mortality, number of ICU-free days
Advisors who reviewed the patient information sheet Expert Reviewers Dr. Peter Vadas, Head, Division of Allergy and Clinical Immunology, St. Michael’s Hospital Dr. Baruch Jakubovic, Division of Clinical Immunology, Department of Medicine, University of Toronto Dr. Silvana Spadafora, Medical Oncologist/Chief of Staff, Algoma District Cancer Program, Sault Area Hospital Dana Root, Lead Oncology Pharmacist, Windsor Regional Hospital Diana Incekol, Advanced Practice Nurse Educator, Princess Margaret Cancer (...) with a drug’s mechanism of action. 1,2 The incidence of IRs varies depending on the anticancer agent used. In some cases, the incidence of reactions may be low but the risk for potentially life-threatening reactions exists. 2,3 Most IRs occur within the first hour of either the first or second administration of an intravenous anticancer medication; therefore, careful monitoring during infusion initiation is necessary to detect potential IRs and manage accordingly. 3 In cases where IRs may be prevented
2, 12 ? Lack of neonate specific or appropriate medications available ? Changing pharmacokinetic parameters at various developmental stages ? Inability to communicate with care providers about their therapy ? Need for multiple calculations, dilutions and manipulations to individualize doses based on age, weight, body surface area, and/or available dosage forms. Calculations need to be frequently repeated as patients grow and gain weight leading to dose adjustments. ? Lack of drugdelivery (...) at risk of experiencing a problem with their medicines while in hospital. Main inclusion criteria: inpatients >16 years in general medical and surgical wards or secondary or tertiary care centres. Studies of inpatients in specialist centres like intensive care were excluded. 2. Research from systematic reviews published from 2013 to 2018 includes more comprehensive clinical settings: intensive care, critical care, diverse patient groups (neonates – elderly patients) and medicationdelivery processes
- usual frequency during the initial withdrawal period without the fear of causing rebound MOH. The drugs proposed for the treatment of headache dur- ing withdrawal as a bridging therapy are those rec- ommended for the acute migraine attack, e.g. diphenhydramine , dihydroergotamine , anti- dopaminergic drugs (chlorpromazine, prochlorper- azine, metoclopramide, droperidol) [95-98], valproic acid , ketorolac , magnesium  or corticos- teroids [12,103]. Many medications have been (...) studied as short-term therapy in a limited number of case series. Pascual and Berciano  concluded that naproxen, a long- acting non-steroidal anti-in?ammatory drug, was ben- e?cial as a rescue medication for patients with MOH. Tizanidine has been studied as an adjunct to a long- acting non-steroidal anti-in?ammatory drug and was shown to be helpful . Patients overusing opiates, barbiturates and tranquilizers may require long-acting opioids, phenobarbital and clonidine as a transition during
A preliminary study on plasma concentration achieved following intrapterygomandibular space injection of dexamethasone as a route of drugdelivery with lignocaine inferior alveolar nerve block-correlation of clinical effects. To determine the quantity of dexamethasone plasma concentration achieved following intrapterygomandibular space injection of dexamethasone when co-administered with inferior alveolar nerve block correlating with the clinical effects in the postoperative phase.A preliminary (...) prospective study to evaluate the dexamethasone plasma concentration achieved following intrapterygomandibular space injection of dexamethasone with 2% lignocaine inferior alveolar nerve block to achieve hemi-mandibular anesthesia for minor oral surgical procedures and derive clinical correlations.Dexamethasone is a glucocorticoid, chiefly used for the management of postsurgical sequelae like trismus and swelling in maxillofacial surgical practice. Conventionally, parenteral dexamethasone is administered