Search results for "Pain Medicine"
showing 10 items of 1037 documents
New approaches on diagnosis and treatment of venous thromboembolism
2014
Summary Pulmonary embolism (PE) and deep vein thrombosis (DVT) are two clinical presentations of venous thromboembolism (VTE) and share the same predisposing factors. In patients admitted to a hospital the rationale use of thromboprophylaxis is based on the high prevalence of VTE amongst hospitalised patients, the adverse consequences of unprevented VTE, and the efficacy of thromboprophylaxis. There is no doubt about the benefit/risk ratio of perioperative venous thromboembolism prophylaxis, but for a safety performance of regional anaesthesia, particularly neuraxial blocks, an appropriate management based on safety intervals suited to the characteristics of the drug is needed. The first st…
The ultra-thin bronchoscope in management of the difficult paediatric airway
1987
The use of an ultra-thin flexible fiberoptic bronchoscope with a single lumen diameter of 2.7 mm at the distal tip to assist intubation of paediatric patients with a difficult airway is reported. Two patients (ages 30 months and 18 months) with mandibular hypoplasia and one patient (three months) with the Pierre-Robin syndrome are reported. In each case two fiberoptic bronchoscopes were used. The first allowed introduction of topical local anaesthetic while the second and smaller one was used for tube placement.
Physiopathological rationale of using high-flow nasal therapy in the acute and chronic setting: A narrative review
2019
Abstract Chronic lung disease and admissions due to acute respiratory failure (ARF) are becoming increasingly common. Consequently, there is a growing focus on optimizing respiratory support, particularly non-invasive respiratory support, to manage these conditions. High flow nasal therapy (HFNT) is a noninvasive technique where humidified and heated gas is delivered through the nose to the airways via small dedicated nasal prongs at flows that are higher than the rates usually applied during conventional oxygen therapy. HFNT enables to deliver different inspired oxygen fractions ranging from 0.21 to 1. Despite having only recently become available, the use of HFNT in the adult population i…
Anesthetics and Cerebral Protection in Patients Undergoing Carotid Endarterectomy
2015
EREBRAL ISCHEMIA/HYPOXIA may occur in a vari-ety of perioperative circumstances. The main pathophy-siologic aspects involved in cerebral ischemia/reperfusion arecaused by adenosine triphosphate (ATP) consumption, theexcitotoxic actions of glutamate, changes in ionic homeostasis,and formation of free radicals (Fig 1). Outcomes from suchevents range from subclinical neurocognitive deficits to cata-strophic neurologic morbidity or death.
Correlates and importance of neglect-like symptoms in complex regional pain syndrome
2018
Neglect-like symptoms (NLS) are frequently observed in complex regional pain syndrome (CRPS). The clinical meaning of NLS, however, is largely unknown. Therefore, this study sets out to assess the importance of NLS for patient outcome and to explore their clinical correlates. We assessed NLS in a group of 53 patients with CRPS and compared the results to 28 healthy volunteers. To define the origin of the NLS reports, we tested the subjective visual midline, performed a limb-laterality recognition test, and quantitative sensory testing. In addition, psychological and pain assessment scales were completed. Tests were analyzed with univariate and multivariate approaches. After 6 months, patien…
Fasting does not guarantee empty stomach in the intensive care unit: A prospective ultrasonographic evaluation (The NUTRIGUS study).
2021
BACKGROUND In the intensive care unit (ICU), a fasting period is usually respected to avoid gastric aspiration during airway management procedures. Since there are no recognised guidelines, intensive care physicians balance the aspiration risk with the negative consequences of underfeeding. Our objective was to determine the impact of fasting on gastric emptying in critically ill patients by using gastric ultrasound. MATERIAL AND METHODS Among the 112 patients that met the inclusion criteria, 100 patients were analysed. Gastric ultrasonography was performed immediately before extubation. Patients with either 1/ an absence of visualised gastric content (qualitative evaluation) or 2/ a gastri…
The rodent tibia fracture model: A critical review and comparison with the complex regional pain syndrome literature
2018
Abstract Distal limb fracture is the most common cause of complex regional pain syndrome (CRPS), thus the rodent tibia fracture model (TFM) was developed to study CRPS pathogenesis. This comprehensive review summarizes the published TFM research and compares these experimental results with the CRPS literature. The TFM generated spontaneous and evoked pain behaviors, inflammatory symptoms (edema, warmth), and trophic changes (skin thickening, osteoporosis) resembling symptoms in early CRPS. Neuropeptides, inflammatory cytokines, and nerve growth factor (NGF) have been linked to pain behaviors, inflammation, and trophic changes in the TFM model and proliferating keratinocytes were identified …
C5a complement and cytokine signaling mediate the pronociceptive effects of complex regional pain syndrome patient IgM in fracture mice.
2020
It has been proposed that complex regional pain syndrome (CRPS) is a posttraumatic autoimmune disease. Previously, we observed that B cells contribute to CRPS-like changes in a mouse tibia fracture model, and that early (12 months duration) CRPS patient IgM antibodies have pronociceptive effects in the skin and spinal cord of muMT fracture mice lacking B cells. The current study evaluated the pronociceptive effects of intraplantar or intrathecal injections of early CRPS IgM (5 µg) in muMT fracture mice. Skin and lumbar spinal cord were collected for immunohistochemistry and polymerase chain reaction analyses. Wild-type mice exhibited postfracture increases in complement component C5a and it…
Osteoprotegerin: a new biomarker for impaired bone metabolism in complex regional pain syndrome?
2014
Abstract Osteoprotegerin (OPG) is important for bone remodeling and may contribute to complex regional pain syndrome (CRPS) pathophysiology. We aimed to assess the value of OPG as a biomarker for CRPS and a possible correlation with radiotracer uptake in 3-phase bone scintigraphy (TPBS). OPG levels were analyzed in 23 CRPS patients (17 women; mean age 50 ± 9.0 years; disease duration: 12 weeks [IQR 8–24]), 10 controls (6 women; mean age 58 ± 9.6 years) and 21 patients after uncomplicated fractures (12 women; mean age: 43 ± 15 years; time after fracture: 15 weeks [IQR: 6–22]). The CRPS and control patients also underwent TPBS. OPG in CRPS patients was significantly increased by comparison wi…
Pain and clinical findings in the low back: a study of industrial employees with 5-, 10-, and 28-year follow-ups.
2009
Little is known about the relationships of clinical findings in the low back with low back pain (LBP) in the normal working population. We studied whether physiotherapist's findings in the low back were associated with local and radiating LBP among a cohort (n=902) of employees in the engineering industry. A systematic non-proportional sample was drawn in strata by age, gender, and occupational class. The non-proportionality aimed at increasing sample size in smaller strata. Physiotherapists performed the straight-leg raising test (SRL), and made assessments of the fingertip-to-floor distance and pain in palpation of the lumbar interspinous spaces. The variables on pain at the interspinous …