Articles: function.
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Randomized Controlled Trial
Ultrasound-Guided Percutaneous Electrical Nerve Stimulation versus Surgery for Women with Unilateral Carpal Tunnel Syndrome: A Randomized Parallel-group Trial.
The aim of this clinical trial was to compare the outcomes of the application of ultrasound-guided percutaneous nerve stimulation (PENS) targeting the median nerve versus surgery for improving pain and function in women with CTS. ⋯ The application of percutaneous nerve stimulation was more effective at short-term, but similar effective at mid and long-term, than surgery in women with carpal tunnel syndrome.
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Critical care medicine · Aug 2023
Randomized Controlled TrialIV Vitamin C in Adults With Sepsis: A Bayesian Reanalysis of a Randomized Controlled Trial.
The Lessening Organ Dysfunction with Vitamin C trial showed a harmful effect of vitamin C on 28-day death or persistent organ dysfunction. To maximize interpretation, we present a post hoc Bayesian reanalysis. ⋯ The use of vitamin C in adult patients with proven or suspected infection and vasopressor support is associated with high probability of harm.
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Curr Opin Anaesthesiol · Aug 2023
ReviewTotal intravenous anesthesia versus inhalation anesthesia: how do outcomes compare?
Surgical procedures that involve general anesthesia are performed with either volatile anesthetics or propofol-based total intravenous anesthesia. Both techniques are safe and provide appropriate conditions for surgery. Despite being a well established anesthetic, the use of propofol-based total intravenous anesthesia (TIVA) remains low. Possible explanations include the perceived increase risk of awareness, lack of target controlled infusion devices, increased turnover time for device set up and individual preference. ⋯ In this review we will summarize the clinical evidence comparing the effect of propofol-based TIVA and volatile anesthetic on postoperative outcomes such as postoperative nausea and vomiting, postoperative pain, quality of recovery, postoperative cognitive dysfunction and cancer outcomes.
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Adaptations in somatosensory function characterize several chronic pain conditions, including nonspecific neck pain (NNP). Early signs of central sensitization (CS) contribute to pain chronification and poor treatment responses after conditions such as whiplash injury and low back pain. Despite this well-established association, the prevalence of CS in patients with acute NNP, and accordingly, the potential impact of this association, is still unclear. Therefore, this study aimed to investigate whether changes in somatosensory function occur during the acute phase of NNP. ⋯ Changes in somatosensory function occur already in acute NNP. Local mechanical hyperalgesia demonstrated peripheral sensitization, while enhanced pain facilitation, impaired conditioned pain modulation, and self-reported symptoms of CS suggest adaptations in pain processing already early in the stage of NNP.
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Chronic pain is a major health problem given its high prevalence and its multiple consequences on the physical and psychological functioning of patients. It is therefore important to determine the relationship between these consequences and pain management strategies such as activity pacing. This review aimed to examine the association between activity pacing and the level of negative emotions in chronic pain. A second objective was to explore sex differences in this association. ⋯ Pacing is multidimensional and consists of various strategies of pain management which are not equally associated with negative emotions. It is important to use measures reflecting this conception to strengthen knowledges about the role of pacing in the development of negative emotions.