Current Controlled Trials ISRCTN78882965.

Objectives:To examine the feasibility and potential efficacy of 5% lidocaine medicated plaster for acute postoperative pain in a parallel, blinded, randomized controlled pilot trial.Methods:Twenty-eight women undergoing elective gynecological surgery with midline incisions were randomly allocated 5% lidocaine medicated patch (Lignopad) or placebo plasters. Postoperative pain at rest and on movement at 24 hours were the primary study endpoints, with secondary endpoints of postoperative pain within the first 48 hours, cumulative morphine consumption (mg), predicted peak flow rate (PFR) (%) and adverse effects. We assessed pain scores at rest and on movement using the visual analogue scale (0–100).Results:The lidocaine patch group had lower postoperative pain scores at rest at 24 hours (mean difference [MD] −15.1, 95% confidence interval [95% CI] −28.3 to −2.0; P = .024) but not on movement at 24 hours (MD −6.4, 95% CI −22.7 to 9.9; P = .445). Compared to placebo, lidocaine may slightly lower cumulative morphine consumption (mg) over time (MD −3.4, 95% CI −6.9 to 0.2; group∗time interaction P = .065). The difference in improvement in the PFR over time after surgery between groups appeared small (group∗time P = .0980). No adverse effects occurred.Conclusions:Lidocaine patch may provide a clinically important reduction in postoperative pain intensity. A larger trial to confirm the efficacy and safety of lidocaine patch is feasible after modifying the inclusion criteria and collecting patient-centered outcomes, such as quality of recovery and patient satisfaction.

This paper reports the prevalence rate of hepatitis B antigen (HBsAg) amongst the Hong Kong Chinese adolescents (age 11 to 19), and the risk factors associated with HBsAg positive. The study is cross sectional and 1,580 students were randomly selected from 12 secondary schools in four regions of Hong Kong. For those subjects who agreed to participate and were randomly selected, their blood was tested for HBsAg and anti-HBs. The overall prevalence of HBsAg positive was reported to be 5.8% (7.9% in male and 4.1% in female), lower than 8.1% in 1978. Males, those born in Mainland China and family history of carriers had higher prevalence of HBsAg positive (7.9% vs 4.1%, 12.2% vs 4.7%, 52.9% vs 3.8% respectively) with statistical significance. Males and those born in mainland China were found to have significantly higher odds ratio 1.8 (95% CI. 0.98-3.52) and 4.4 (95% CI. 2.2-8.8) respectively of HBsAg positive by multivariate analysis. Findings suggest that family history of carriers and those born in endemic area are at a higher risk. Therefore it is worthwhile to consider vaccination programme for adolescents to reduce the carrier rate, and to also reduce the injection amongst the adults by horizontal transmission.

Laparoscopic liver resection for hepatocellular carcinoma appears to be safe and to achieve acceptable oncologic outcomes even in cirrhotic livers, but whether it is comparable to conventional open surgery needs to be evaluated in a randomized, controlled trial setting.

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e10214th International Congress on Infectious Diseases (ICID) Abstracts demic. The last of these is called Swine flue (influenza A H1N1), which since its inception has caused great alarm, high morbidity and mortality especially in pregnant women. This is a sample of the features of the disease in Dominican Republic.Dominican Republic is a tropical country located in the Caribbean that receive substantial annual number of tourists, which makes influenza outbreaks throughout the year: both seasonal peaks in the northern and southern hemisphere.Methods: The Epidemiology National Program starts a surveillance since the epidemic arise at level 5, at epidemiological week 16.Diagnosis confirmation was made with rt-PCR for A H1N1 to all symptomatic respiratory cases.Results: Until the 40th epidemiology week, we have 2,664 suspicious cases, 997 (37%) hospitalized, 441 confirmed cases, from this 191 (45%) hospitalized, and 22 (5%) death, 76 (17%) cases were pregnant women with 16% mortality.Clinical manifestations were: fever (94%), cough (89%), nasal congestion (76%), headache (71%), muscle pain (67%), sore throat (60%), dyspnoea (45%), nausea (25%), rales (21%), vomiting (18%) and diarrhoea (11%).Pregnancy was one of the more important risk factor associated with mortality.Necropsy findings where: edema, hemorrhage and necrosis in lung tissues, frequently associate with intravascular thrombosis.High mortality was cause due a delay in search of medical attention and no suspected diagnosis from health cares personel.Conclusion: It must be increased the Primary Care Services to obtain an early diagnosis of the disease, and began the antiviral treatment in high risk populations, when this pathology is suspected, mostly in pregnant women.