BioMed research international
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The aim of this study was to assess the influence of unilateral posterior crossbite on the electrical activity of the temporal and masseter muscles in patients with subjective symptoms of temporomandibular dysfunctions (TMD). The sample consisted of 50 patients (22 female and 28 male) aged 18.4 to 26.3 years (mean 20.84, SD 1.14) with subjective symptoms of TMD and unilateral posterior crossbite malocclusion and 100 patients without subjective symptoms of TMD and malocclusion (54 female and 46 male) aged between 18.4 and 28.7 years (mean 21.42, SD 1.06). The anamnestic interviews were conducted according to a three-point anamnestic index of temporomandibular dysfunction (Ai). ⋯ Recordings were carried out in the mandibular rest position and during maximum voluntary contraction (MVC). Analysis of the results of the EMG recordings confirmed the influence of unilateral posterior crossbite on variations in spontaneous muscle activity in the mandibular rest position and maximum voluntary contraction. In addition, there was a significant increase in the Asymmetry Index (As) and Torque Coefficient (Tc), responsible for a laterodeviating effect on the mandible caused by unbalanced right and left masseter and temporal muscles.
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Randomized Controlled Trial Comparative Study
Comparison of Propofol, Propofol-Remifentanil, and Propofol-Fentanyl Administrations with Each Other Used for the Sedation of Patients to Undergo ERCP.
Using single anesthetic agent in endoscopic retrograde cholangiopancreatography (ERCP) may lead to inadequate analgesia and sedation. To achieve the adequate analgesia and sedation the single anesthetic agent doses must be increased which causes undesirable side effects. For avoiding high doses of single anesthetic agent nowadays combination with sedative agents is mostly a choice for analgesia and sedation for ERCP. ⋯ It was observed that, in the patients undergoing ERCP, administration of propofol in combination with an opioid provided effective and reliable sedation, reduced the total dose of propofol, increased the practitioner satisfaction, decreased the pain level, and provided hemodynamic stability compared to the administration of propofol alone.
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Chronic pain represents a major public health problem worldwide. Current pharmacological treatments for chronic pain syndromes, including neuropathic pain, are only partially effective, with significant pain relief achieved in 40-60% of patients. Recent studies suggest that the mammalian target of rapamycin (mTOR) kinase and downstream effectors may be implicated in the development of chronic inflammatory, neuropathic, and cancer pain. ⋯ Enhanced activation of this pathway is present in different experimental models of chronic pain. Consistently, pharmacological inhibition of the kinase activity turned out to have significant antinociceptive effects in several experimental models of inflammatory and neuropathic pain. We will review the main evidence from animal and human studies supporting the hypothesis that mTOR may be a novel pharmacological target for the management of chronic pain.
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Randomized Controlled Trial
Insufflation with humidified and heated carbon dioxide in short-term laparoscopy: a double-blinded randomized controlled trial.
We tested the hypothesis that warm-humidified carbon dioxide (CO2) insufflation would reduce postoperative pain and morphine requirement compared to cold-dry CO2 insufflation. ⋯ Warm, humidified insufflation gas significantly reduces postoperative shoulder-tip pain as well as morphine demand. This trial is registered with Clinical Trial Registration Number DRKS00003853 (German Clinical Trials Register (DRKS)).
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Critical illness is characterized by glutamine depletion owing to increased metabolic demand. Glutamine is essential to maintain intestinal integrity and function, sustain immunologic response, and maintain antioxidative balance. Insufficient endogenous availability of glutamine may impair outcome in critically ill patients. ⋯ Recently, this scientifically sound recommendation has been questioned, primarily based on controversial findings from a large multicentre study published in 2013 that evoked considerable uncertainty among clinicians. The present review was conceived to clarify the most important questions surrounding glutamine supplementation in critical care. This was achieved by addressing the role of glutamine in the pathophysiology of critical illness, summarizing recent clinical studies in patients receiving parenteral nutrition with intravenous glutamine, and describing practical concepts for providing parenteral glutamine in critical care.