Articles: chronic.
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Review Case Reports
Acquired pharmaco-dynamic opioid tolerance: a concept analysis.
To report an analysis of the concept of acquired pharmaco-dynamic opioid tolerance. ⋯ Untangling the antecedents, empirical referents and consequences of tolerance help healthcare professionals understand its complexities. Improved knowledge may ultimately influence patient outcomes through the construction of better monitoring systems. This concept analysis may also provide insights for policy change and give empirical direction for future research.
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This is a selective narrative review of the latest information about the epidemiology, impact, and prevention of chronic post-surgical pain (CPSP), intended primarily for those without a special interest in pain medicine. ⋯ Reduction of CPSP is a worthy long-term outcome for anesthesia providers to consider as they plan the perioperative care of their patients. More evidence is needed about the effect of currently used analgesics and other perioperative techniques on CPSP.
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Jordanian cancer patients' information needs and information-seeking behaviour: a descriptive study.
Cancer diagnosis can leave patients with uncertainty and anxiety that can be reduced by providing timely information and effective communication. Despite information provision being highly important in improving the quality of provided care, no study had been conducted to assess the information needs of Jordanian cancer patients. ⋯ Many factors may cause variations in patients' information-seeking behaviour. Therefore, a notational policy for information provision is needed to satisfy different patients' information needs. Healthcare providers should be aware that cancer patients' will continue to need information at all stages.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Feb 2014
Review[Nutrition of the critically ill - Is less more? How much energy for the ICU patient?].
Decreased nutritional intake or preexisting malnutrition is associated with increased morbidity and mortality during hospital stay. However nutritional support in particular for the ICU patient is not trivial. ⋯ Ideally about 25 kcal/kg/d should be targeted over a few days during metabolic monitoring. Alternatively indirect calorimetry should be applied where available.
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The persistence of pain after surgery increases the recovery interval from surgery to a normal quality of life. AYX1 is a DNA-decoy drug candidate designed to prevent post-surgical pain following a single intrathecal injection. Tissue injury causes a transient activation of the transcription factor EGR1 in the dorsal root ganglia-dorsal horn network, which then triggers changes in gene expression that induce neuronal hypersensitivity. ⋯ Administered in the peri-operative period, AYX1 dose dependently prevents mechanical hypersensitivity in models of acute incisional (plantar), inflammatory (CFA), and chronic neuropathic pain (SNI) in rats. Furthermore, in a knee surgery model evaluating functional measures of postoperative pain, AYX1 improved weight-bearing incapacitance and spontaneous rearing compared to control. These data illustrate the potential clinical therapeutic benefits of AYX1 for preventing the transition of acute to chronic post-surgical pain.