Articles: chronic.
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Leaders in the fields of Temporomandibular Disorders (TMD) and its accompanying overlapping pain conditions presented their latest findings at the Seventh Scientific Meeting of The TMJ Association, September 7-9, 2014, in Bethesda, MD. The meeting was co-sponsored by The TMJ Association and the National Institutes of Health. Topics of the scientific sessions included epidemiology and diagnostic criteria, basic mechanisms of chronic pain including the genetic and epigenetic basis of chronic pain, and the development of novel drugs for treatment of these conditions. Discussions were directed toward formulating a set of recommendations to advance research in this field.
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Editorial Comment
Chronic kidney disease: a gateway for perioperative medicine.
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ICUs are increasingly staffed with nurse practitioners/physician assistants (NPs/PAs), but it is unclear how NPs/PAs influence quality of care. We examined the association between NP/PA staffing and in-hospital mortality for patients in the ICU. ⋯ NPs/PAs appear to be a safe adjunct to the ICU team. The findings support NP/PA management of critically ill patients.
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Case Reports
Refining the ultrasound-guided interscalene brachial plexus block: the superior trunk approach.
The conventional ultrasound-guided interscalene block targets the C5 and C6 nerve roots at approximately the level of the cricoid cartilage where they lie in the groove between the anterior and middle scalene muscles. This technique, although effective at providing regional anesthesia of the shoulder, is associated with risks of phrenic nerve palsy, injury to the dorsal scapular and long thoracic nerves, and long-term postoperative neurologic symptoms. In this case report, we describe the ultrasound-guided superior trunk block. This procedure targets the C5 and C6 components of the brachial plexus more distally after they unite into the superior trunk but before the suprascapular nerve branches off. ⋯ The enhanced anatomical knowledge provided by ultrasound-guidance has allowed anesthesiologists to devise new block techniques and refine existing ones. The superior trunk block is an example of this refinement and is intended as an alternative to the conventional interscalene block for anesthesia of the shoulder. Further research is planned to confirm the efficacy and safety of the technique.