Revue médicale de Liège
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Revue médicale de Liège · Nov 2008
Review[Transdermal buprenorphine: a current overview of pharmacological and clinical data].
Our understanding of the pathophysiologic mechanisms of chronic pain progresses; the complexity of the problem justifies our need for new molecules and new ways of administration that will help to further optimise and better individualize our pharmacologic therapies. Whereas acute pain can be considered an alarm signal, chronic pain constitutes, per se, a syndrome that requires a meticulous selection of the analgesic drug(s). Since pain is permanent, the continuous administration of the analgesic is recommended rather than an on demand administration. ⋯ Buprenorphine also exerts an analgesic action on neuropathic pain. It differs from other opioids by its affinity as a partial agonist on mu and kappa receptors, and as a complete agonist of ORL-1 receptors. Therefore, transdermal buprenorphine will be useful to all physicians having to control severe pain by powerful opioids.
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Pulmonary involvement is rare in Horton's disease. Only few cases have been reported presenting as interstitial infiltration, pulmonary artery vasculitis, pulmonary nodules and granulome formation. Pleural effusion was rarely reported. ⋯ Outcome was favourable with systemic corticosteroid therapy. Pleural involvment in Horton's disease is rare and characterized the absence of specific biological and histological findings. However, pleural effusion may be a presenting manifestation of Horton's disease.