Articles: chronic.
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Reg Anesth Pain Med · Mar 2014
Case ReportsDyskinesia Caused by Ziconotide-Baclofen Combination in an Adolescent Affected by Cerebral Palsy.
To report on the first case of ziconotide-induced dyskinesia. Ziconotide, a synthetic peptide analogue of the ω-conotoxin MVIIA that blocks selectively N-type voltage-sensitive calcium channels, has been used in intrathecal administration for 30 years. Ziconotide is a drug of choice for chronic pain because of its efficacy and flexibility because it can substitute or complement other intrathecal therapies including morphine or baclofen. Whereas substantial information is available regarding its efficacy, systematic data regarding the safety of ziconotide remain scant. The adverse reactions to ziconotide described so far regard only the coordination and execution of intentional movements. ⋯ An analysis of the signaling pathways of baclofen and ziconotide revealed a possible drug interaction that allowed ziconotide to trigger dyskinesia.
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Reg Anesth Pain Med · Mar 2014
A Prospective Validation of Biplanar Ultrasound Imaging for C5-C6 Cervical Medial Branch Blocks.
Ultrasound (US) guidance offers an alternative to fluoroscopy for medial branch blocks of the upper cervical spine, but it may be less accurate for blocks at the C5 and C6 levels. We hypothesized that a modified technique using biplanar US imaging would facilitate level identification and provide greater accuracy for the lower cervical spine. ⋯ Ultrasound guidance using a biplanar approach is a reliable imaging modality for C5 and C6 medial branch blocks.
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Reg Anesth Pain Med · Mar 2014
Ghrelin Alleviates Neuropathic Pain Through GHSR-1a-Mediated Suppression of the p38 MAPK/NF-κB Pathway in a Rat Chronic Constriction Injury Model.
Neuropathic pain is related to the sustained activation of neuroglial cells and the production of proinflammatory cytokines in the spinal dorsal horn. Ghrelin, the endogenous ligand for growth hormone secretagogue receptor 1a (GHSR-1a), has been shown to inhibit the activation of microglia and the release of proinflammatory cytokines. The purpose of this study was to investigate the role of ghrelin/GHSR-1a signaling in neuropathic pain and to understand the associated mechanisms. ⋯ Our present study demonstrated that ghrelin alleviated neuropathic pain through a GHSR-1a-mediated suppression of the p38 MAPK/NF-κB pathway.
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Randomized Controlled Trial Multicenter Study
The relationship between hypophosphataemia and outcomes during low-intensity and high-intensity continuous renal replacement therapy.
To identify risk factors for development of hypophosphataemia in patients treated with two different intensities of continuous renal replacement therapy (CRRT) and to assess the independent association of hypophosphataemia with major clinical outcomes. ⋯ Hypophosphataemia is common during CRRT and its incidence increases with greater CRRT intensity. Hypophosphataemia is not a robust independent predictor of mortality. Its greater incidence in the higher intensity CRRT arm of the Randomised Evaluation of Normal vs Augmented Level trial does not explain the lack of improved outcomes with such treatment.
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Respiratory Support PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Non invasive ventilation (NIV) ia a technical support in patients with acute or chronic respiratory failure. The NIV is used in patients with obesity hypoventilation syndrome (OHS) presenting with hypercapnic respiratory failure. Few studies examine the evolution and impact after starting this therapy in this patient group Objectives: To evaluate the result of non invasive ventilation started in obese patients in acute hypercapnic respiratory failure (AHRF) and its prognosis consequences. Asses the impact of long-term NIVMETHODS: Observational study with consecutive inclusion of obese patients with AHRF treated with NIV from February 2008 to June 2011. Obesity: BMI>30kg/m; AHRF: pH<7.35 and PaCO2> 45mmHg. Treatment: NIV started in general or respiratory wards and emergency department ⋯ The following authors have nothing to disclose: Concepcion Romero, Jesús Sánchez, Virginia Almadana, Ana Gómez-Bastero, Patricia Guerrero, Agustin Valido, Jose María Benítez, Teodoro MontemayorNo Product/Research Disclosure Information.