No-Opioid Strategy Sharply Reduced Prescribing After Urologic Cancer Surgery
A protocol focusing on non-opioid pain control measures, as well as patient education, helped eliminate the need for post-discharge opioid prescriptions after major urologic cancer surgery, according to a cohort study. Among nearly 650 opioid-naive patients, the rate of opioid prescriptions at discharge was 57.9% for those who received an instruction sheet that explained the […]
Shorter Course of Radiation Therapy Proves Mettle in High-Risk Prostate Cancer
SAN ANTONIO — A shortened radiation therapy (RT) protocol for high-risk prostate cancer led to similar outcomes with no increase in toxicity compared with the standard treatment schedule, a randomized trial showed. Overall survival (OS) at 7 years was 82%, with no difference between standard RT and hypofractionation that reduced treatment duration from 8 to […]
Catheter-Directed Thrombolysis Promising for Intermediate-Risk Pulmonary Embolism
A modified reperfusion protocol for intermediate-risk pulmonary embolism (PE) seemed to work without causing excessive bleeding in the small randomized CANARY trial. Use of conventional catheter-directed thrombolysis (CDT) with alteplase led to 4.3% of patients showing right ventricular (RV) recovery at 3 months (in terms of echocardiographic RV/LV ratios >0.9), which was numerically, but not […]
Less Fluid Not Better for Septic Shock
A more restrictive protocol for IV fluids didn’t reduce mortality for adults in the ICU receiving treatment for septic shock, the CLASSIC trial showed. Restricting IV crystalloid fluids to small boluses only for severe hypoperfusion, to replace documented fluid losses, or for dehydration and electrolyte deficiency for patients who couldn’t take fluids enterally yielded a […]
Ablating High-Grade Anal Lesions Thwarts Progression to Cancer
A protocol in which high-grade squamous intraepithelial lesions (HSIL) of the anal canal were immediately treated was more effective for preventing incidence of anal cancer in people with HIV, a randomized trial found. In the study involving nearly 4,500 individuals with anal HSIL detected by screening, nine of those assigned to aggressive therapy — mostly […]