British journal of anaesthesia
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There are many patient groups who may refuse blood products; the most well known amongst them is the Jehovah's Witness faith. Treatment of anaemia and bleeding in such patients presents a challenge to medical, anaesthetic, and surgical teams. This review examines the perioperative issues and management of Jehovah's Witnesses. The history and beliefs of Jehovah's Witnesses are outlined together with their impact on ethics and the law, and different management options throughout the perioperative period are discussed.
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Randomized Controlled Trial Comparative Study
Comparison of contrast flow and clinical effectiveness between a modified paramedian interlaminar approach and transforaminal approach in cervical epidural steroid injection.
The different methods of cervical epidural injection include the median or paramedian interlaminar (PI) approach and the transforaminal (TF) approach. We hypothesized that the modified PI (mPI) approach could deliver drugs suitably and safely into the anterior epidural space compared with the TF approach. ⋯ This result suggests that the mPI approach allows for suitable and safe delivery of drugs into the anterior epidural space.
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Clinical Trial
Epidermal growth factor receptor - inhibition (EGFR-I) in the treatment of neuropathic pain.
Neurobiological work has demonstrated that expression of mitogen-activated protein kinases (MAPK) is upregulated on neurones and glial cells after nerve damage. Furthermore, the epidermal growth factor receptor (EGFR) has been identified as having a key role in this process and subsequent interruption of this using EGFR-Inhibitors (EGFR-I), may improve neuropathic pain. The aim of this report was to explore if EGFR-I attenuated neuropathic pain in humans. ⋯ EGFR-I improves neuropathic pain and this is in keeping with basic science work. Controlled clinical trials are now eagerly awaited to assess this further.
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Comparative Study
Tracheal tube biofilm removal through a novel closed-suctioning system: an experimental study.
Tracheal tube biofilm develops during mechanical ventilation. We compared a novel closed-suctioning system vs standard closed-suctioning system in the prevention of tracheal tube biofilm. ⋯ The novel CSS reduces biofilm accumulation within the tracheal tube. A clinical trial is required to confirm these findings and the impact on major outcomes.