Articles: human.
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Despite opioid analgesics being essential for pain relief, use has been inadequate in many countries. We aim to provide up-to-date worldwide, regional, and national data for changes in opioid analgesic use, and to analyse the relation of impediments to use of these medicines. ⋯ International Narcotics Control Board, UN.
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Clin J Am Soc Nephrol · Apr 2016
ReviewAnti-CD20 Antibodies for Idiopathic Nephrotic Syndrome in Children.
Rituximab, a chimeric anti-CD20 monoclonal antibody originally licensed for lymphoma, is emerging as a novel steroid-sparing agent for idiopathic nephrotic syndrome in children. The potential use of anti-CD20 monoclonal antibodies in idiopathic nephrotic syndrome has contributed to shifting the view of podocytopathies from T cell-mediated to more complex immunomediated disorders that can benefit from targeting B cells and other mediators of the early immune response. Clinical data on the use of rituximab also have implications on disease management and classification. ⋯ Insufficient data are available on optimal use of rituximab as a maintenance steroid-sparing agent in these steroid-sensitive forms of the disease, including how often and for how long rituximab infusions should be repeated to maximize expected benefits and minimize potential harms. Finally, one randomized controlled trial in children with steroid-resistant idiopathic nephrotic syndrome yielded negative results. New anti-CD20 antibodies are under study in this patient population.
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Anesthesia and analgesia · Apr 2016
Clinical Concentrations of Local Anesthetics Bupivacaine and Lidocaine Differentially Inhibit Human Kir2.x Inward Rectifier K+ Channels.
Inward rectifier K channels of the Kir2.x subfamily are widely expressed in neuronal tissues, controlling neuronal excitability. Previous studies reported that local anesthetics (LAs) do not affect Kir2 channels. However, the effects have not been studied at large concentrations used in regional anesthesia. ⋯ The results indicate that both LAs at clinical concentrations equilibrated rapidly with the intracellular milieu, differentially inhibiting Kir2.x channel function from the cytoplasmic side.
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Zika virus (ZIKV) is an enveloped RNA virus that belongs to the Flaviviridae family. Although more than 60 years have passed since the discovery and first reported human cases of the virus, only a small number (< 10) of cases had been encountered in the literature until the last 10 years. Zika virus was known as a virus which caused sporadic infections and was confined to Africa and Asia along a narrow equatorial line. ⋯ In addition, concurrent with outbreaks in 2013 in French Polynesia and in 2015 in Brazil, there have been significant rises reported in the incidence of some autoimmune and neurodevelopmental disorders, including Guillain-Barre syndrome and microcephaly; these reports have caused considerable international concern. There are many points that are still unclear about ZIKV, including: (1) intrauterine transmission risk, frequency, and effects of the infection on fetal development; (2) the probability of perinatal transmission and if so the possible risks; (3) association with autoimmune and neurological diseases, and presence of long-term sequelae risks after infection; (4) possible routes of transmission other than mosquito bites, such as sexual contact, blood transfusion, and other body fluids (saliva, semen, or urine); (5) presence of reservoir(s) and different mosquito vectors; (6) diagnostic difficulties including cross reactivity in serological tests and standardization of testing procedures; (7) severity of the infection in immunocompromised patients; and (8) the potential effectiveness of antiviral therapy or preventive vaccines. In this review, updated information and recommendations regarding ZIKV outbreaks and risks, and the epidemiology, diagnosis and characteristics of ZIKV infections, are summarized in light of the most recent literature.