Medicinski pregled
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Neuropathic pain, or pain associated with disease or injury to the peripheral or central nervous system, is a common symptom of a heterogeneous group of conditions, including diabetic neuropathy; trigeminal neuralgia, postherpetic neuralgia and spinal cord injury. Chronic neuropathic pain should not be thought of as a symptom. It should truly be thought of as a disease with a very complicated pathophysiology. ⋯ There are many new agents and new applications of the existing agents being currently studied which will most certainly lead to even more improved ways of managing this very complicated set of disorders.
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According to the World Health Organisation, counterfeit medicines are medicines that are mislabelled deliberately and fraudulently regarding their identity and/or source. All kinds of medicines have been counterfeited, both branded and generic ones. Counterfeit medicines may include products containing correct or wrong ingredients; without active or with insufficiently or over-active ingredients, or with fake packaging. ⋯ Pharmacists and doctors should stay vigilant and report suspicious products, and consider counterfeits as a possible cause of adverse reactions or therapeutic failure. Patients should inform their pharmacists and doctors if they suspect any irregularity concerning their medication, if they experience side effects or a decrease in beneficial effect. The crucial step in the prevention of counterfeit medicines is to get supplied from reliable sources, i.e. licensed pharmacies.
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Drowning is a leading preventable cause of unintentional morbidity and mortality. The dominant pathophysiological mechanism of drowning includes the development of acute hypoxia. ⋯ In drowning, the victim with cardiac arrest requires advanced life support, including an early intubation. Extended medical measures, which are primarily provided by medical professionals, include cervical spine immobilization in case a spinal injury is suspected, or, establishment of the ventilation with oxygen, emergency transport, application of reanimation and advanced vital support measures.
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Convulsive status epilepticus is the most urgent neurological medical emergency in children. Generalized convulsive status epilepticus is the most common and life-threatening type of status epilepticus. It is not a syndrome in the same sense as febrile convulsions, benign rolandic epilepsy, and infantile polymorphic epilepsy. These latter disorders have a tight age frame, seizure semiology, and a reasonably predictable outcome. Episodes of convulsive status epilepticus can occur in each: occasionally in symptomatic and febrile convulsions, and Lennox Gastaut syndrome, rarely in benign rolandic epilepsy, and West syndrome. ⋯ Status epilepticus is a disorder in which the mechanisms attempting at terminating the seizure fail. Continued convulsive activity in convulsive status epilepticus results in decompensation of all organs and systems, thus being life threatening. Seizure activity in convulsive status epilepticus is associated with neuronal damage. The aim should be to halt this activity urgently, using, ideally, a 100% effective drug, administered quickly, without compromising the consciousness level or producing other negative effects on cardiovascular, respiratory function or other unexpected effects.
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Fibromyalgia (FM) is a chronic pain condition with spontaneous, chronic, widespread musculoskeletal pain and tenderness accompanied by a number of nonspecific symptoms. The low prevalence of FM is considered an underestimation and results from insufficient knowledge about FM In order to increase the general awareness of the unique nature of pain in fibromyalgia and the right of patients to receive specific attention, EFIC (European Federation of the IASP Chapters) launched the European campaign against pain in fibromyalgia. ⋯ According, to multiple pathophysiological mechanisms, the treatment involves multidisciplinary and multimodal approach, including a combination of pharmacological and non-pharmacological interventions based on EULAR (European League Against Rheumatism) recommendations from 2007. Pharmacological treatment (antidepressants, anticonvulsants and conventional analgesics) is directed toward the control of pain and other symptoms, but nonpharmacological management (aerobic exercise, strength training and cognitive behavioural therapy) is directed to functional consequences of the symptoms. Although the treatment rarely relieves the symptoms completely the active role of an educated FM patient and supportive surrounding are secondary necessary to provide beneficial clinical effects on this complex painful condition.