Articles: chronic.
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Randomized Controlled Trial Comparative Study
Effect of oxygen and acetazolamide on nocturnal cardiac conduction, repolarization and arrhythmias in pre-capillary pulmonary hypertension and sleep-disturbed breathing.
Sleep-disturbed breathing (SDB) is common in patients with precapillary pulmonary hypertension (PH). Nocturnal oxygen therapy (NOT) and acetazolamide improve SDB in patients with PH, and NOT improves exercise capacity. We investigated the effect of NOT and acetazolamide on nocturnal cardiac conduction, repolarization, and arrhythmias in patients with PH and SDB. ⋯ In patients with PH with SDB, NOT reduces nocturnal heart rate and QTc in the morning, thus, favorably modifying prognostic markers.
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Critical care medicine · Nov 2014
Multicenter StudyLow-Dose Corticosteroid Treatment in Septic Shock: A Propensity-Matching Study.
Given conflicting data and current guidelines, low-dose corticosteroids are often used in the treatment of septic shock. To evaluate the therapeutic benefit of early low-dose corticosteroid in patients with septic shock. ⋯ Early administration of low-dose corticosteroid is not associated with decreased mortality when it is administered to unselected patients with septic shock. A beneficial effect of low-dose corticosteroid on mortality may exist in patients with the highest severity of illness. Future trials of low-dose corticosteroid in septic shock should consider restricting the study population to this cohort.
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A survey on teaching ultrasound-guided chronic pain procedures in pain medicine fellowship programs.
Over the last decade ultrasound guidance (USG) has been utilized very successfully in acute pain procedures to confirm nerves' anatomic location and obtain live images. Not only the utilization, but the teaching, of USG has become an essential part of anesthesiology residency training. Prior to the introduction of USG, chronic pain procedures were always done either under fluoroscopy or blindly. USG offers advantages over fluoroscopy for completion of chronic pain procedures. USG decreases radiation exposure and the expenses associated with operating a fluoroscopy machine and allows live visualization of soft tissues and blood flow, a feature that fluoroscopy does not directly offer. Even today, the utilization and teaching of the technique for chronic pain procedures has not been as widely accepted as in acute pain management. ⋯ The teaching of ultrasound guided chronic pain procedures varies significantly between individual programs. Though many program directors do require that fellows demonstrate competency in the technique before graduation, as of today there is no ACGME guideline regarding this. The advancement in ultrasound technology and the increase in number of trained faculty may significantly impact the use of USG in training fellows to perform chronic pain procedures.
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The shoulder joint is an enarthrodial or ball-and-socket joint. A complex network of anatomic structures endows the human shoulder with tremendous mobility, greater than any other joint in the body. Many pathologies can been found in those patients with chronic shoulder pain. ⋯ Her pain and shoulder range of motion in all planes improved dramatically. Peripheral nerve stimulation (PNS) of the suprascapular nerve, in addition to multimodality pain management, is one approach to the difficult task of treating adhesive capsulitis with accompanying pain and the inability to move the shoulder. We conducted a literature review on PubMed and found no case describing a similar patient to our knowledge.
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Multicenter Study
The First Postoperative Day: Prospective Evaluation of Pain in Adult Otorhinolaryngologic Surgery.
The aim of the study was to assess postoperative pain within the first 24 hours after otorhinolaryngologic surgery and to identify factors influencing postoperative pain. ⋯ Analgesia and perioperative pain management in otorhinolaryngologic surgery seems to be highly variable. After otorhinolaryngologic surgery many patients seem to receive less analgesia than needed or ineffective analgesic drug regimes.