1.Opioid switching to oxycodone injection using simple conversion ratio
Tsuyoshi Miyahara ; Toshifumi Kosugi ; Ayumi Nita ; Sasagu Hamada ; Atsuko Hiura ; Naomi Mori ; Yuki Hachiya ; Naomi Hirakawa ; Hidetoshi Sato ; Hisashi Matsunaga
Palliative Care Research 2014;9(4):125-130
Purpose: The simple conversion ratio of 1:1:1/50 between oxycodone injection (OXJ), morphine injection and fentanyl injection is used at Saga-Ken Medical Centre Koseikan. However, there are no studies on the validity of the simple conversion ratio. Methods: A total of 18 patients with opioid switching to OXJ using the simple conversion ratio were reviewed in this investigation. We surveyed the change in the numeric rating scale (NRS) and adverse effects before and after opioid switching. Result: The average period needed to reach a stable dose of OXJ was 0.6 days. The reasons of opioid switching to OXJ were the uncontrolled cancer pain in 11 patients, the impossibility of oral administration in 6 patients, the drowsiness in 1 patient. The average NRS decreased from 3.3 to 1.1 in 11 patients with uncontrolled cancer pain (p=0.007). No obvious change in the NRS was observed in 6 patients with the impossibility of oral administration. In 18 patients, there was no significant difference in adverse effects before and after opioid switching. Conclusion: These results indicate that the simple conversion ratio could be safety for opioid switching between OXJ and other opioid in cancer pain treatment.
2.Assessing the utility of osteoporosis self-assessment tool for Asians in patients undergoing hip surgery
Keisuke UEMURA ; Kazuma TAKASHIMA ; Ryo HIGUCHI ; Sotaro KONO ; Hirokazu MAE ; Makoto IWASA ; Hirohito ABE ; Yuki MAEDA ; Takayuki KYO ; Takashi IMAGAMA ; Wataru ANDO ; Takashi SAKAI ; Seiji OKADA ; Hidetoshi HAMADA
Osteoporosis and Sarcopenia 2024;10(1):16-21
Objectives:
Diagnosis and treatment of osteoporosis are instrumental in obtaining good outcomes of hip surgery.Measuring bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis. However, due to limited access to DXA, there is a need for a screening tool to identify patients at a higher risk of osteoporosis. We analyzed the potential utility of the Osteoporosis Self-assessment Tool for Asians (OSTA) as a screening tool for osteoporosis.
Methods:
A total of 1378 female patients who underwent hip surgery at 8 institutions were analyzed. For each patient, the BMD of the proximal femoral region was measured by DXA (DXA-BMD), and the correlation with OSTA score (as a continuous variable) was assessed. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of OSTA score to predict osteoporosis. Lastly, the OSTA score was truncated to yield an integer (OSTA index) to clarify the percentage of patients with osteoporosis for each index.
Results:
DXA-BMD showed a strong correlation with OSTA (r = 0.683; P < 0.001). On ROC curve analysis, the optimal OSTA score cut-off value of − 5.4 was associated with 73.8% sensitivity and 80.9% specificity for diagnosis of osteoporosis (area under the curve: 0.842). A decrease in the OSTA index by 1 unit was associated with a 7.3% increase in the probability of osteoporosis.
Conclusions
OSTA is a potentially useful tool for screening osteoporosis in patients undergoing hip surgery. Our findings may help identify high-risk patients who require further investigation using DXA.