Medical science monitor : international medical journal of experimental and clinical research
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The aim of this investigation was to evaluate the theoretical framework of regionalized trauma care that places highest expertise at Level I and II Trauma Centers. ⋯ The study raises the question whether regionalization in its current form is the appropriate framework for the organization of trauma care in Texas. Small variation in survival among trauma centers with highest expertise, indicate the need to revisit the entire concept of regionalized trauma care or particular elements of its structure. One solution suggested here is to have multiple centers with similar expertise at the core of the system acting as "Trauma Hospitals" which would connect with all the other hospitals in the region regardless of their expertise in an integrative model.
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Comparative Study
Comparison of the local anesthetic effects of chlorpheniramine, midazolam, lidocaine, and normal saline after intradermal injection.
Local anesthetic effects of antihistamines are well known, but have been tested more for diphenhydramine than for chlorpheniramine. Midazolam, a benzodiazepine gamma-aminobutyric acid type A receptor agonist, induces spinally mediated analgesia. However, the local anesthetic effects of chlorpheniramine and midazolain have not been adequately studied. The purpose of this study was to assess the infiltration pain and the local anesthetic effects of intradermial chlorpheniramine and midazolam. ⋯ Intradermal chlorpheniraline, but not midazolam, produced a local anesthetic effect; however, the duration of this effect of chlorpheniramine was shorter than that of lidocaine.
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Comparative Study
Serum magnesium and calcium ions in patients with severe pre-eclampsia/eclampsia undergoing magnesium sulfate therapy.
Magnesium sulfate is used for seizure therapy and prophylaxis in women with eclampsia and preeclampsia worldwide. Magnesium may act by opposing calcium-dependent arterial constriction and may also antagonize the increase in intracellular calcium concentration. The objectives were to study the alterations in serum ionized magnesium and calcium and their relationship in patients with severe pre-eclampsia/eclampsia receiving magnesium sulfate therapy. ⋯ Magnesium ion does not appear to exert its therapeutic effect in pre-eclampsia/eclampsia by substantially modulating serum ionized calcium. However, the effect of exogenous Mg on intracellular calcium cannot be ruled out.
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The study investigated the effect of peak inspiratory flow in a rabbit acute lung injury model. ⋯ Compared with volume-control ventilation with V(T) (20 ml/kg), pressure-regulated volume-control ventilation with the same V(T) worsened oxygenation, histological injury score in tipper lobes, and wet-to-dry ratio in rabbits with injured lungs. The evidence suggests that greater deterioration in gas exchange and lung injury is associated with high inspiratory flow.
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Review
Autonomic dysfunction and cardiac repolarization abnormalities in patients with migraine attacks.
The clinical symptoms of migraine are widely accepted to be related to the involvement of the autonomic nervous system, and especially to dysfunction in the regulation of the circulatory system and autonomic balance. Disturbance of the autonomic nervous system is a primary characteristic of migraine Therefore, patients with migraine have a variety of symptoms, such as vasodilatation (flushing), pilo-erection, nausea, vomiting, diarrhea, cutaneous vasoconstriction (pallor), and diaphoresis. The electrocardiographic changes seen during a migraine attack compared with the pain-free period could be secondary to reversible disturbances of the state of autonomic innervation of the heart and coronary arteries. ⋯ However, there is no information in literature reporting the frequency of cardiac arrhythmias in migraine patients who had cardiac repolarization abnormalities. In this review, detailed electrocardiographic findings and their relation with the autonomic nervous system, including recent observations, have been evaluated. However, further studies are needed to investigate the association between autonomic dysregulation and cardiac repolarization abnormalities in patients with migraine.