Articles: cations.
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The pre-hospital use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasing, although it remains controversial, in part because of suggested contraindications such as acute cardiac tamponade (ACT). As both the pre-hospital and in-hospital use of REBOA might potentially occur with concurrent ACT, knowledge of the hemodynamic effect of REBOA in this setting is crucial. This study, therefore, aimed at investigating the physiological effects of REBOA in hemodynamic instability secondary to ACT in a porcine model. We hypothesize that REBOA can temporarily increase systemic blood pressure and carotid blood flow, and prolong survival, in hemodynamic shock caused by ACT. ⋯ This randomized animal study demonstrates that REBOA can help provide hemodynamic stabilization and prolong survival in hemodynamic shock provoked by ACT. It is important to stress that our study does not change the fact that urgent pericardiocentesis or cardiac surgery is, and should remain, the standard optimal treatment for ACT.Level of evidence: Prospective, randomized, experimental animal study. Basic science study, therapeutic.
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Case Reports
Scrambler Therapy for the Treatment of Multiple System Atrophy-Parkinsonian Subtype Pain: A Case Report.
The management of pain in patients with multiple system atrophy (MSA) is often inadequate, and treatments commonly result in adverse effects. A 63-year-old man with the parkinsonian subtype of MSA presented with bilateral neck, shoulder, upper extremity, lower extremity, and low back pain of 6 years' duration. His baseline pain was 5 of 10 with flares to 10 of 10. ⋯ His pain relief after 4 ST sessions lasted for 6 weeks. No complications or adverse effects occurred. ST deserves further study for patients with atypical parkinsonism.