Articles: disease.
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Neurogenic inflammation results from the release of neuropeptides from peripheral nerve terminals. This secretion can be induced by two mechanisms: activation of afferent sensory nerves (e.g. by disease processes or experimentally by electrical stimulation) or activation of receptors expressed on peripheral nerve terminals. While the role of these mechanisms in the regulation of inflammation is well described, its significance for the generation of pain is much less clear and will be examined in this review. ⋯ While considerable experimental and clinical evidence supports the existence of neurogenic inflammation, it is less clear whether this process plays an important role in the generation of pain.
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The Trench Foot was described during the Napoleon's wars but its clinical picture dates from 1915. As a result of soldiers' life in trenches, it was recognized as a neurological, circulatory and infectious disease which struck thousands of fighters (chiefly French and English). ⋯ More than 200 papers were published about the Trench Foot and the numerous individual inventions to protect the soldier's foot from mud, rain, cold and compression. As this issue is found in most testimonies of the fighters that proves it was a real and further suffering in the trenches.
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The next couple of decades will be characterized by an increase in life expectancy, leading to an older population. As the incidence of Alzheimer's dementia and vascular dementia is rising with age, the future anaesthesiologist will be increasingly confronted with perioperative care of patients with impaired cognitive function. This paper tries to highlight some topics specifically related to demented patients. ⋯ Anaesthesia in the demented patient may be complicated by a number of potential problems, including the comorbid pathology, the concomitant anticholinesterase activity, the need for normoventilation, monitoring of anaesthesia depth and the evaluation of postoperative pain. Anaesthesia in variant Creutzfeldt-Jakob disease is aimed at preventing the spread of the causing prion. There is a broad consensus that early return to the preoperative level of cognition is to be pursued, with the help of short-acting drugs and loco-regional anaesthesia.
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Preventive medicine · May 2004
Meta AnalysisA meta-analysis of alcohol consumption and the risk of 15 diseases.
To compare the strength of evidence provided by the epidemiological literature on the association between alcohol consumption and the risk of 14 major alcohol-related neoplasms and non-neoplastic diseases, plus injuries. ⋯ This meta-analysis shows no evidence of a threshold effect for both neoplasms and several non-neoplastic diseases. J-shaped relations were observed only for coronary heart disease.
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An update on recent developments in diagnosis and treatment of disseminated intravascular coagulation. ⋯ Whereas antithrombin and tifacogin failed to improve clinical outcome in severe sepsis, drotrecogin alpha (activated) increased the chances of survival of patients with severe sepsis with and without disseminated intravascular coagulation.