Search results for "Anesthesia"

Intravenöse Immunglobulin- und Prednisolon-Behandlung bei kryoglobulinämischer Polyneuropathie

2001

A 71-year-old man with cryoglobulinemia associated with severe symmetrical sensorimotor polyneuropathy was successfully treated with intravenous immunoglobulin (IVIG) and a corticosteroid. Within 2-3 months, he developed distal motor and sensory deficits and burning feet deteriorating after cold exposure. On examination, symmetric hypesthesia and hypalgesia were found along with bilateral loss of vibration and position sense, loss of ankle jerks, and paralysis of the pretibial muscles with step-page gait. The laboratory exam revealed elevated cryoglobulin levels and reduced complement C4. Nerve conduction studies were consistent with a severe axonal sensorimotor polyneuropathy. Sural nerve …

Germinal matrix hemorrhage-intraventricular hemorrhage: pathogenesis and outcomes

2015

Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) is one of the CNS injuries affecting preterm infants occurring in about 15%-20% of subjects weighing less than 1500 g. Currently, using ultrasonography, we recognize three grades of GMH-IVH. Grade I involving the subependymal parenchyma and/or extending in less than 10% of the ventricle, grade II with intraventricular bleeding not expanding in more than 50% of the ventricle, grade III characterized by consistent (> 50%)intraventricu- lar bleeding with ventricular dilatation. A concomitant intraparenchymal lesion (IPL), due to a venous infarction (ex grade IV), can be associated with any grade of IVH, worsening the prognosis. P…

Seizure following the Use of the COX-2 Inhibitor Etoricoxib

2017

We describe a case of epileptic seizures occurring after the use of a COX-2 inhibitor. A 61-year-old man was admitted to our department because of a generalized tonic-clonic seizure. EEG showed generalized slowdown of the activity. Neuroimaging and blood samples studies did not evidence alterations, but a careful pharmacological history revealed that the patient had taken the COX-2 inhibitor etoricoxib to treat lumbago few days before the onset of clinical symptoms. No seizures were reported after etoricoxib discontinuation and an EEG resulted to be normal two months after this. Conclusion. Knowing the pharmacological history of a patient is important for understanding the clinical presenta…

A second-degree atrioventricular block with double escape rhythm secondary to paroxysmal vagal hypertonia.

2017

Determination of Drug Concentrations in Serum and Dopamine Receptor Occupancy in Brain for Optimal Antipsychotic Drug Therapy

2009

Evidence has been given that antipsychotic effects of dopamine receptor antagonists are associated with 60 and 80% striatal dopamine D2 and D3 receptor occupancy. Receptor occupancy correlates well with concentrations of the antipsychotic drugs in serum or plasma, much better than the dose. The latter is consistent with weak correlations between antipsychotic dose and serum concentrations and explained by the high interindividual variabilities in drug metabolism. Using positron emission tomography (PET) for in vivo determination of dopamine receptor occupancy in conjunction with drug concentration measurements “therapeutic windows” could be calculated for the atypical antipsychotic drugs am…

Visualization of inert gas wash-out during high-frequency oscillatory ventilation using fluorine-19 MRI

2010

High-frequency oscillatory ventilation is looked upon as a lung-protective ventilation strategy. For a further clarification of the physical processes promoting gas transport, a visualization of gas flow and the distribution of ventilation are of considerable interest. Therefore, fluorine-19 magnetic resonance imaging of the imaging gas octafluorocyclobutane (C(4) F(8) ) during high-frequency oscillatory ventilation was performed in five healthy pigs. For that, a mutually compatible ventilation-imaging system was set up and transverse images were acquired every 5 sec using FLASH sequences on a 1.5 T scanner. Despite a drop in signal-to-noise ratio after the onset of high-frequency oscillato…

Root damage induced by intraosseous anesthesia'An in vitro investigation

2012

Objectives: The principle of the intraosseous anesthesia (IOA) relies on the perforation of the cortical plate of the bone for direct application of the local anesthetic solution into the underlying cancellous structures. During this procedure, IOA needles might accidentally come in contact with the tooth roots. The aim of the current in vitro study was to examine the consequences of this ‘worst case scenario’ comparing five commercially available IOA systems. Material and Methods: Extracted human roots were randomly perforated using five different IOA systems with a drilling time ≤5s. To simulate normal in vivo conditions, the roots were kept humid during the drilling procedure. Data was s…

Treatment of pulmonary embolism.

2015

International audience; The treatment of pulmonary embolism is going to be deeply modified by the development of Direct Oral Anticoagulants (DOACs). There are currently three anti-Xa factors (rivaroxaban, apixaban, edoxaban) and one anti-IIa factor (dabigatran) labeled by the FDA and the EMA. All these drugs are direct anticoagulant, orally effective, without the need for adaptation to hemostasis test. As kidney excretion is involved for all of them, they are contra-indicated in patients with severe renal failure (creatinine clearance<30mL/min according to Cockcroft & Gault formula). All the anti-Xa factor drugs are metabolized by liver cytochromes and then contra-indicated in case of liver…

Combined oral prolonged-release oxycodone and naloxone in chronic pain management

2013

Introduction: The use of opioids is associated with unwanted adverse effects, particularly opioid-induced constipation (OIC). The adverse effects of opioids on gastrointestinal function are mediated by the interaction with opioid receptors in the gastrointestinal tract. The most common drugs used for relieving OIC are laxatives, which do not address the opioid receptor-mediated bowel dysfunction and do not provide sufficient relief. Areas covered: This paper discusses the role of a combination of prolongedrelease formulation of oxycodone (OX) and naloxone (N) in the prevention and management of OIC, reporting efficacy and safety outcome of controlled studies. In a therapeutic area of great …

Potential drug-drug interaction between duloxetine and acenocoumarol in a patient with Alzheimer's disease

2007

Abstract Background : Recent evidence suggests that duloxetine may increase the effect of warfarin, thereby increasing the possibility of bleeding. However, a MEDLINE search for articles published between 1980 and May 2007 (terms: duloxetine , anticoagulants , acenocoumarol , and interaction ; no language restriction) did not yield any reports of an interaction between concomitant use of duloxetine and acenocoumarol. Objective : The aim of this study was to describe a potential drug-drug interaction between duloxetine and acenocoumarol in a patient with Alzheimer's disease. The possible mechanism of this potential interaction is examined. Case summary : This report presents the case of a 63…