Articles: chronic.
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Anesthesia and analgesia · Aug 2022
Historical ArticleJohn Henry Evans, MD: Founding Chairman of the Board of Governors of the International Anesthesia Research Society, and a Forgotten Pioneer of Oxygen Therapy.
The theoretical and practical foundations of modern oxygen therapy were established during the first half of the 20th century. John Henry Evans, MD, inaugural chairman of the Board of Governors of the International Anesthesia Research Society (IARS), was an early pioneer in this field. ⋯ Additionally, Evans experimented with the subcutaneous injection and intravenous infusion of oxygen, reporting significant benefits of the former in several acute inflammatory conditions, as well as a variety of chronic ailments. While these contributions have largely been forgotten, Evans expanded the remit of anesthesiology beyond the operating theater and the original charter of the IARS and helped lay the foundations for the rational use of oxygen as a therapeutic agent in all areas of medicine.
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In 2020, the COVID-19 virus sparked a crisis constituting a nationwide public health emergency that rapidly altered the provision of healthcare services for all Americans. Infectious disease mitigation led to widespread lockdowns of perceived nonessential services, programs, and non-emergent healthcare interventions. This lockdown exacerbated the public health dyad of uncontrolled pain and the opioid epidemic, which was already in a crisis state. Current literature supports the management of uncontrolled pain with a biopsychosocial approach, empowering patients to explore self-care to enhance activities of daily living. Pain Coping Skills Training (PCST) delivers real-life strategies that improve quality of life and strengthen self-efficacy. Self-efficacy has been identified as a patient outcome measure that demonstrates improved patient-perceived function and quality of life despite pain intensity. Studies have shown that nurse practitioners (APRN) are well-positioned to provide PCST to chronic pain sufferers. ⋯ This project concluded that a Nurse Practitioner delivered PCST program via telehealth technology could provide community-dwelling adults with an intervention that improves pain self-efficacy, enhances self-reported PEG measures, and meets the social distancing requirements that continue to impact patients during the COVID-19 pandemic.
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Case Reports
Retrolaminar Continuous Nerve Block Catheter for Multiple Rib Fractures: A Case Report.
Rib fractures carry high morbidity and mortality due to pain-related complications, such as hypoventilation, atelectasis, and pneumonia. Ultrasound-guided regional anesthesia is a common treatment for pain associated with rib fractures. ⋯ In these instances, it is advantageous to have a tactile or landmark-based approach to treating rib fracture pain. We present a case of a continuous retrolaminar nerve block catheter placed without ultrasound guidance in a 67-year-old man with oxygen-dependent chronic obstructive pulmonary disease and a prior intrathecal pump, who presents with multiple unilateral rib fractures.
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Journal of neurosurgery · Aug 2022
Repeated intravenous infusion of mesenchymal stem cells for enhanced functional recovery in a rat model of chronic cerebral ischemia.
Stroke is a major cause of long-term disability, and there are few effective treatments that improve function in patients during the chronic phase of stroke. Previous research has shown that single systemic infusion of mesenchymal stem cells (MSCs) improves motor function in acute and chronic cerebral ischemia models in rats. A possible mechanism that could explain such an event includes the enhanced neural connections between cerebral hemispheres that contribute to therapeutic effects. In the present study, repeated infusions (3 times at weekly intervals) of MSCs were administered in a rat model of chronic stroke to determine if multiple dosing facilitated plasticity in neural connections. ⋯ These results indicate that repeated systemic administration of MSCs over 3 weeks resulted in greater functional improvement as compared to single administration and/or vehicle infusion. In addition, administration of MSCs is associated with promotion of interhemispheric connectivity through the CC in the chronic phase of cerebral infarction.