Ongoing quest for a better predictor of difficult airway Rakesh Garg Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):431-432 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
A comparative analysis of femoral nerve block with adductor canal block following total knee arthroplasty: A systematic literature review Yugal Karkhur, Ramneek Mahajan, Abhimanyu Kakralia, Amol Prabhakar Pandey, Mukul Chandra Kapoor Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):433-438 Background: Patients undergoing total knee arthroplasty suffer from moderate-to-severe postoperative pain resulting in immobility-related complications and prolonged hospitalization. Femoral nerve block is associated with reduction in the quadriceps strength and increasing incidence of falls. Adductor canal block has been shown to be as effective as femoral nerve block without causing quadriceps weakness. Objectives: To compare outcomes of studies comparing adductor canal block and femoral nerve block in patients undergoing primary total knee arthroplasty. Data Sources: Original articles, published between July 2013 and April 2017, comparing the above interventions. Study Eligibility Criteria, Participants, and Interventions: Comparison of outcome measures of all original articles shortlisted by the PUBMED and Google Scholar databases search using key words, “adductor canal block; femoral nerve block; total knee arthroplasty; total knee replacement.” Study Appraisal and Synthesis Methods: The primary outcome measures reviewed were: pain scores; interventional failure; post-operative opioid consumption; patient fall or near fall during postoperative rehabilitation; and length of stay. Results: The opioid consumption was found to be comparable with both the interventions on the first and second postoperative day. Patients administered adductor canal block had better quadriceps power, longer ambulation distance, and shorter length of hospital stay. Limitations: Of the studies reviewed five were retrospective and thus data quality amongst the studies may have been compromised. Conclusions and Implications of Key Findings: Mobilization and ambulation, which are both important for recovery after total knee arthroplasty are both inhibited less by adductor canal block. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Strategies for prevention of lower limb post-amputation pain: A clinical narrative review Vanita Ahuja, Deepak Thapa, Babita Ghai Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):439-449 Postamputation limb pain or phantom limb pain (PLP) develops due to the complex interplay of peripheral and central sensitization. The pain mechanisms are different during the initial phase following amputation as compared with the chronic PLP. The literature describes extensively about the management of established PLP, which may not be applicable as a preventive strategy for PLP. The novelty of the current narrative review is that it focuses on the preventive strategies of PLP. The institution of preoperative epidural catheter prior to amputation and its continuation in the immediate postoperative period reduced perioperative opioid consumption (Level II). Optimized preoperative epidural or intravenous patient–controlled analgesia starting 48 hours and continuing for 48 hours postoperatively decreased PLP at 6 months (Level II). Preventive role of epidural LA with ketamine (Level II) reduced persistent pain at 1 year and LA with calcitonin decreased PLP at 12 months (Level II). Peripheral nerve catheters have opioid sparing effect in the immediate postoperative period in postamputation patients (Level I), but evidence is low for the prevention of PLP (Level III). Gabapentin did not reduce the incidence or intensity of postamputation pain (Level II). The review in related context mentions evidence regarding therapeutic role of gabapentanoids, peripheral nerve catheters, and psychological therapy in established PLP. In future, randomized controlled trials with long-term follow-up of patients receiving epidural analgesia, perioperative peripheral nerve catheters, oral gabapentanoids, IV ketamine, or mechanism-based modality for prevention of PLP as primary outcome are required. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Meloxicam in the management of post-operative pain: Narrative review Alex Bekker, Carolyn Kloepping, Shemille Collingwood Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):450-457 Oral formulations of meloxicam, a preferential cyclooxygenase-2 (COX-2) inhibitor, have long been used to treat osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, as well as various pain syndromes of skeletomuscular origin (e.g., low back pain). However, these preparations are rarely indicated for the treatment of acute pain due to a poor dissolution rate and consequently a slow onset of action. The recent introduction of an intravenous (IV) NanoCrystal Colloidal Dispersion formulation opens up the possibility of using this drug during the perioperative period. The present review summarizes the pharmacologic properties of meloxicam, including its pharmacokinetics, adverse effects, and tolerability. In addition, we critically examined a number of recently completed clinical trials that evaluated the efficacy and safety of meloxicam IV in the treatment of post-operative pain. Literature retrieval was performed through PubMed and Medline (through March 2018) using combinations of the terms meloxicam, acute pain, and pharmacology. In addition, bibliographical information, including contributory unpublished data, was requested from the company developing the drug. Clinical trials suggest that single IV doses of 30 mg meloxicam significantly reduce post-operative pain as well as opioid requirements. We conclude that meloxicam IV is an effective and well-tolerated analgesic agent for the management of moderate to severe post-operative pain. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Peripheral nerve blocks for above knee amputation in high-risk patients Rajkumar Chandran, Zhi Yuen Beh, Fung Chen Tsai, Suran Dhanushka Kuruppu, Jia Yin Lim Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):458-464 Background and Aims: Above knee amputation (AKA) is associated with considerable mortality and morbidity. There is paucity of data describing the use of peripheral nerve blocks (PNB) as the sole anesthetic technique in high-risk patients undergoing AKA. Our objectives were to evaluate the use of PNB as sole anesthetic technique in the above-mentioned population and its clinical outcomes. Material and Methods: This was a retrospective descriptive study conducted in a tertiary hospital. For this study, patients with American Society of Anesthesiologist [ASA] IV physical status underwent AKA using PNB between January 2010 and December 2016, were identified. The primary outcome measured was the success of the operation. The secondary outcomes were block details, intraoperative hemodynamics, usage of sedation and analgesia, patients' comorbidities, mortality rates at 30 days and one year. Results: Out of fifty-seven patients, the median age (interquartile range) was 74 (57 – 81) years and 60% were males. The results show 91% successfully underwent surgery with PNB (95% CI 81% to 96%). 95% required intraoperative sedation and analgesia. 67% received combined femoral, obturator and sciatic nerve blocks, in which nine cases had an additional lateral femoral cutaneous nerve block. Interestingly, 33% only received combined femoral and sciatic nerve blocks, and they required higher sedation analgesia (p = 0.013). The 30-day and one-year mortality were 12.3% & 47.4%. Majority had stable hemodynamics during the surgery. Conclusion: This study shows that PNB is a viable option for reliable anesthesia for AKA in high-risk patients. Combined FOS nerve block would reduce the dose for sedation–analgesia during the operation. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Association between intravenous acetaminophen and reduction in intraoperative opioid consumption during transsphenoidal surgery for pituitary tumors Upasana Banerjee, Katherine Hagan, Shreyas Bhavsar, Roxana Grasu, Anh Dang, Ian E McCutcheon, Miguel Suarez, Vijaya Gottumukkala, Juan P Cata Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):465-471 Background and Aims: Pain during and after transsphenoidal surgeries originates from stimulation of branches of the trigeminal cranial nerve that supply the inner aspect of the nose cavity and dura mater. Thereby, patients undergoing transsphenoidal surgery may require moderate-to-large amounts of analgesics including opioids. Intravenous acetaminophen provides analgesia and reduces opioid consumption for a wide variety of surgeries. We hypothesized that the use of intravenous acetaminophen is associated with a reduction in intraoperative opioid consumption and provides significant analgesia during and after transsphenoidal surgery. Material and Methods: This retrospective study included 413 patients who underwent transsphenoidal surgery for pituitary adenomas. The primary outcome of this study was intraoperative opioid consumption. Secondary outcomes included pain intensity, Richmond Agitation Sedation Scale scores, and nausea and vomiting upon arrival to postoperative anesthesia care unit. Patients were divided into two groups based on the intraoperative acetaminophen use. A prospensity score matching analysis was used to balance for important variables between the two groups of treatment. Regression models were fitted after matching the covariates. A P < 0.05 was considered statistically significant. Results: After matching, 126 patients were included in each group of treatment. Patients in the acetaminophen group required significantly less amount (a decrease by 14.9%) of opioids during surgery than those in the non-acetaminophen group. Postoperative pain, postoperative nausea and vomiting, and sedation scores were not significantly different between patients who received intravenous acetaminophen and those who did not. Conclusion: Intravenous acetaminophen is associated with a reduction in intraoperative opioids during transsphenoidal pituitary surgery. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Transversus abdominis plane block supplementation during iliac crest bone graft harvesting – Effect on postoperative pain Usha Shenoy, Vigil Peter, Philip Mathew, Tom Thomas Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):472-477 Background and Aims: Transversus abdominis plane (TAP) block is a technique proposed to minimise pain after anterior iliac crest bone harvesting. This study aims to evaluate the postoperative pain in patients who receive ultrasound-guided TAP block to supplement routine wound infiltration. Material and Methods: A total of 143 patients aged between 6 and 22 years were randomised into two groups. Patients in group A received supplemental TAP block on the same side. Patients in group B received local anesthetic wound infiltration alone. Pain scores were compared at the first and 24th postoperative hours. Results: TAP block significantly reduced pain and delirium in the immediate postoperative period. The mean FLACC (Face, Legs, Activity, Cry, Consolability) score after 10 min was 0.8 in group A versus 1.8 in group B (P = 0.001). The mean Watcha scale at 10 min was 1.0 in group A versus 1.2 in group B (P = 0.001). After 24 h, 81.7% of patients in group A had no pain versus 59.7% in group B (P = 0.004). The incidence of intolerable pain at 24 h was 5.6% in group B versus 0% in group A (P = 0.04). Cumulative ambulation scores were significantly better in group A (P < 0.05). There was a strong and positive correlation between the analgesia and ability to ambulate comfortably at 24 h postop (Pearson's coefficient 0.95). Conclusion: Supplemental ultrasound-guided TAP block given intraoperatively reduces the postoperative pain. The incidence of emergence delirium was low. These patients were also able to ambulate earlier. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Postoperative pain management practices and their effectiveness after major gynecological surgery: An observational study in a tertiary care hospital Samina Ismail, Ali S Siddiqui, Azhar Rehman Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):478-484 Background and Aims: Despite advances in postoperative pain management, patients continue to experience moderate to severe pain. This study was designed to assess the strategy, effectiveness, and safety of postoperative pain management in patients undergoing major gynecological surgery. Material and Methods: This observational study included postoperative patients having major gynecological surgery from February 2016 to July 2016. Data collected on a predesigned data collection sheet included patient's demographics, postoperative analgesia modality, patient satisfaction, acute pain service assessment of numeric rating scale (NRS), number of breakthrough pains, number of rescue boluses, time required for the pain relief after rescue analgesia, and any complication for 48 h. Results: Among 154 patients reviewed, postoperative analgesia was provided with patient-controlled intravenous analgesia in 91 (59.1%) patients, intravenous opioid infusion in 42 (27%), and epidural analgesia in 21 (13.6%) patients with no statistically significant difference in NRS between different analgesic modalities. On analysis of breakthrough pain, 103 (66.8%) patients experienced moderate pain at one time and 53 (51.4%) at two or more times postoperatively. There were 2 (0.6%) patients experiencing severe breakthrough pain due to gaps in service provision and inadequate patient's knowledge. Moderate-to-severe pain perception was irrespective of type of incision and surgery. Vomiting was significantly higher (P = 0.049) in patients receiving opioids. Conclusion: Adequacy of postoperative pain is not solely dependent on drugs and techniques but on the overall organization of pain services. However, incidence of nausea and vomiting was significantly higher in patients receiving opioids. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Ratio of height to thyromental distance as a predictor of difficult laryngoscopy: A prospective observational study Suvarna Kaniyil, Krishnadas Anandan, Sanjith Thomas Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):485-489 Background and Aim: Various airway indices are used either singly or in combination to predict difficult laryngoscopy. Recently introduced ratio of height to thyromental distance (RHTMD) is reported to have better predictability. We aimed to assess the prediction of difficult laryngoscopy by RHTMD and compared it with other indices. Material and Methods: In this prospective, single-blinded comparative observational study, 300 adult patients of either gender scheduled to receive general anesthesia were assessed. Airway indices, like RHTMD, thyromental distance, modified Mallampati test, and upper lip bite test, were assessed and correlated with Cormack and Lehane's laryngoscopic grading. The validity parameters like specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for each test. Effect of combining all the indices was also analyzed. Receiver operating characteristic curves were constructed and optimal cutoff value for the quantitative indices was calculated. Results: The incidence of difficult laryngoscopy in our study was 5.33%. Of the four indices, the single best test was RHTMD, with better sensitivity, high specificity, NPV, and accuracy and with good PPV. A combination of all the indices resulted in 100% sensitivity and higher specificity. Conclusions: RHTMD is a single best preoperative test for predicting difficult laryngoscopy. A combination of tests has higher sensitivity and specificity with better discriminative power. Therefore indices should be used in combination in the preoperative airway assessment of adult patients. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment of awake i-gel™ insertion for fiberoptic-guided intubation in patients with predicted difficult airway: A prospective, observational study Julian Arevalo Ludena, Jose Juan Arcas Bellas, Rafael Alvarez Rementeria, Luis Enrique Muñoz Alameda Journal of Anaesthesiology Clinical Pharmacology 2018 34(4):490-495 Background and Aims: Orotracheal intubation (OTI) with fiberoptic bronchoscope (FOB) in spontaneous ventilation is one of the main techniques for patients with predicted difficult airway. Latest generation supraglottic airway devices have been designed to allow OTI through them. We assessed the safety and effectiveness of FOB-guided OTI through i-gel™ device which was inserted in spontaneously breathing patients with predicted difficult airway. Material and Methods: Eighty-five patients with difficult airway predictors were included. The i-gel was inserted under oropharyngeal local anaesthesia and sedation. After checking the adequate ventilation through the i-gel with capnography curve, general anaesthesia was induced in order to introduce the endotracheal tube guided by FOB. We recorded the i-gel insertion time (tgel), intubation time (tint), O2 saturation in pulse oximetry (SpO2) at different times: basal (t0), after 3 min of preoxygenation with a face mask at 100% FiO2 (t1), after i-gel mask insertion (t2) and after intubation (t3). Adverse events during the procedure were also recorded. Results: All patients were successfully intubated. SpO2 values were: 96.9 ± 1.2 (t0), 99.0 ± 0.9 (t1), 96.2 ± 2.4 (t2), 96.0 ± 2.5 (t3). tgel and tint were 38.0 ± 7.8 s and 36.5 ± 5.6 s, respectively. No serious adverse events were recorded and no patient suffered airway trauma. Conclusion: I-gel insertion in spontaneous ventilation secures the airway before achieving fiberoptic intubation without the occurrence of adverse events. More studies might be necessary in order to confirm the results presented, but we consider that the technique described is a safe and effective alternative to classic OTI with FOB in spontaneously breathing patients with predicted difficult airway.
|
Αρχειοθήκη ιστολογίου
-
►
2020
(289)
- ► Φεβρουαρίου (28)
-
▼
2019
(9071)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (3642)
-
▼
Ιανουαρίου
(3200)
-
▼
Ιαν 03
(89)
- Elective neck treatment during salvage (pharyngo) ...
- How I treat venous thrombosis in children Contrain...
- Beware of upper airway obstruction in warfarinized...
- Effect of Intra-arterial Nimodipine on Cerebral Ox...
- Videolaryngoscope-assisted nasotracheal intubation
- Extra corporeal membrane oxygenation in the critic...
- Venous air/oxygen embolism due to hydrogen peroxid...
- Vitamin D and childhood asthma: causation and cont...
- Understanding does not depend on (causal) explanation
- Continuous PECS block for anterior shoulder surgery
- Anaesthesiology Clinical Pharmacology
- Kidney agenesis Amelogenesis imperfecta Gingival h...
- Periodontology
- Tuberculosis in larynx
- Respiratory Care
- CD73 expression in normal and pathological human h...
- Large preaxial polydactyly with intraepidermal bul...
- Alterations in intestinal serosal microcirculation...
- Starvation-induced diplopia and weakness: a case o...
- Autoimmunity and immunodeficiency at the crossroad...
- Beer: an uncommon cause of anaphylaxis
- Isolated Schneiderian papilloma of the middle ear ...
- Endovascular embolisation of an iatrogenic superfi...
- Pregnancy, malignancy or mother nature? Persistenc...
- Sialolipoma of Parotid Gland a Rare Histological P...
- Efficacy of Multicomponent Tympanometry in Identif...
- Tracheal Stenosis: Evaluation of an Institutional ...
- Auditory Brainstem Response in Patients of Tinnitu...
- The Goat Model for Exclusive Two Handed Endoscopic...
- Clinical and Audiometric Assessment of Hearing Los...
- Labyrinthectomy: Our Experience in a Tertiary Care...
- Sialolipoma of Parotid Gland a Rare Histological P...
- Efficacy of Multicomponent Tympanometry in Identif...
- Tracheal Stenosis: Evaluation of an Institutional ...
- Auditory Brainstem Response in Patients of Tinnitu...
- The Goat Model for Exclusive Two Handed Endoscopic...
- Clinical and Audiometric Assessment of Hearing Los...
- Labyrinthectomy: Our Experience in a Tertiary Care...
- The Dangers of Button Batteries
- Ossiculoplasty: A Prospective Study on 50 Patients...
- Postoperative Delirium in Patients Undergoing Head...
- YouTube Videos as a Source of Patient Information ...
- Tonsillectomy and Adenoidectomy in Children
- Systematic screening for occupations and occupatio...
- Ossiculoplasty: A Prospective Study on 50 Patients...
- Gründe für die Entstehung von Allergien bei Kindern
- Andrology
- Health Sciences
- Clinical Trials in Degenerative Diseases
- Acute-Onset Optic Neuropathy in Wilson’s Disease
- Predictors of Initial and Sustained Remission in P...
- Travel time to provider is associated with advance...
- Fecal Proteomic Analysis in Healthy Dogs and in Do...
- Electroacupuncture at ST-36 ameliorates DSS-induce...
- Differential growth of craniofacial and tibial bon...
- Atopy in chronic rhinosinusitis: impact on quality...
- Schwann cells shape the neuro-immune environs and ...
- Intratonsillar Abscess: A Not-So-Rare Clinical Entity
- Cochlear Implantation for Single-Sided Deafness in...
- Vestibular and Oculomotor Function in Children wit...
- Clinical presentation and characteristics of lymph...
- Diffuse Large B-Cell Lymphoma of the Lacrimal Sac ...
- The effect of frontal sinus pneumatization on anat...
- A new approach to vocal cord leukoplakia and evalu...
- Clinical pattern of fungal balls in the paranasal ...
- A prospective, non-randomized evaluation of a nove...
- Decreased expression of response gene to complemen...
- Issue Information
- Issue Information
- 代谢综合征和银屑病的风险
- Recent developments in lymph node surgery for mela...
- 心脸皮肤综合症中的皮肤表现
- SLC7A5, SLC7A7, SLC7A8 and TDO2 in basal cell carc...
- Highlights of the updated Dutch evidence‐ and cons...
- Image Gallery: A case of porokeratosis ptychotropica
- 阿达木单抗在斑块型银屑病成人患者中的长期安全性
- Dermatological manifestations in cardiofaciocutane...
- 银屑病和抑郁
- Omalizumab in patients with antihistamine‐resistan...
- Professor Sidney Barski (1918–2018)
- 改善:银屑病和银屑病关节炎中的死亡率
- 托法替布在慢性斑块型银屑病中的获益风险特征
- Tofacitinib benefit‐risk profile in chronic plaque...
- 基底细胞癌中的 SLC7A5、SLC7A7、SLC7A8 和 TDO2
- Metabolic syndrome and risk of psoriasis
- Psoriasis and depression
- News and Notices
- Increased risk of death in patients with psoriasis...
- Patient preferences and patient‐centredness in ski...
-
▼
Ιαν 03
(89)
-
►
2018
(39872)
- ► Δεκεμβρίου (3318)
- ► Σεπτεμβρίου (3683)
- ► Φεβρουαρίου (2693)
- ► Ιανουαρίου (3198)
-
►
2017
(41099)
- ► Δεκεμβρίου (3127)
- ► Σεπτεμβρίου (2173)
-
►
2016
(13807)
- ► Δεκεμβρίου (700)
- ► Σεπτεμβρίου (600)
- ► Φεβρουαρίου (1350)
- ► Ιανουαρίου (1400)
-
►
2015
(1500)
- ► Δεκεμβρίου (1450)
Ετικέτες
Πέμπτη 3 Ιανουαρίου 2019
Anaesthesiology Clinical Pharmacology
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου