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John Zietlow, Kathy Berns, Donald Jenkins, Scott Zietlow
BACKGROUND: The military use of ketamine is well established. The benefits of prehospital civilian use have not been extensively reported. METHODS: A retrospective review was performed of patients with prehospital ketamine use in Mayo One's air and critical care ground transport. RESULTS: The medical records were reviewed from 2014 to 2016 to assess the efficacy of Ketamine. During this time frame, 158 (167 instances) patients were treated with ketamine for analgesia (38%), sedation (44%), or procedural (18%) use...
March 1, 2019: Military Medicine
Steven Cohen, Christopher Gilmore, Leonardo Kapural, Steven Hanling, Anthony Plunkett, Meredith McGee, Joseph Boggs
Chronic low back pain represents one of the most common sources of disability and a significant healthcare burden for the U.S. military. Present treatments for chronic back pain are often ineffective, poorly tolerated, invasive, destructive, and/or associated with complications and lead to the progression to invasive surgical procedures. There have been multiple calls for the development of a minimally invasive system that is effective without the risks or complications of existing surgical therapies, which could prevent the need for surgery and the recurrence of pain...
March 1, 2019: Military Medicine
Khurshid Alam, Steven L A Jeffery
METHODS: Ten patients having split-thickness skin grafting for burn injury were treated with the fish skin xenografts. RESULTS: There were no adverse reactions noted on the use of the fish skin grafts. No patient had any reaction to the fish skin and there was a zero incidence of infection. The handling of the fish skin was excellent, a robust and pliable xenograft that was easy to apply.The quality of donor site healing was judged to be good in all cases. Both the analgesic effect noted and the relatively short average times until 100% re-epithelialization are promising...
March 1, 2019: Military Medicine
Brian M Ilfeld, Scott T Ball, Steven P Cohen, Steven R Hanling, Ian M Fowler, Amorn Wongsarnpigoon, Joseph W Boggs
Orthopedic trauma is a significant military problem, causing several of the most disabling conditions with high rates of separation from duty and erosion of military readiness. The objective of this report is to summarize the findings of case series of a non-opioid therapy-percutaneous peripheral nerve stimulation (PNS) - and describe its potential for postoperative analgesia, early opioid cessation, and improved function following orthopedic trauma. Percutaneous PNS has been evaluated for the treatment of multiple types of pain, including two case series on postoperative pain following total knee replacement (n = 10 and 8, respectively) and a case series on postamputation pain (n = 9)...
March 1, 2019: Military Medicine
Xiong Gao, Piao Zhu, Luodan Yu, Liqun Yang, Yu Chen
Local anesthetics have been extensively employed to treat postoperative pain, but they generally suffer from short acting duration and potential neurotoxicity under high local concentrations, which require the controlled and sustained releasing patterns of treatment drugs. In this work, it is reported, for the first time, the construction of hollow mesoporous organosilica nanoparticles (HMONs)-based nanoplatforms for localized delivery and controlled/sustained release of loaded ropivacaine for local anesthetics, which can be repeatedly triggered by either external ultrasound irradiation or acidity triggering to release the payload, causing on-demand and long-lasting analgesia...
March 22, 2019: Advanced Healthcare Materials
Klaus Orion, Jochen Mack, Gerd A Kullak-Ublick, Stefan Weiler
OBJECTIVE: Kounis syndrome (KS) is an acute coronary syndrome with coronary spasm, acute myocardial infarction and stent thrombosis that can be associated with a variety of drugs as an adverse drug reaction (ADR). To characterize this rare phenomenon, we analyzed all cases of KS in the WHO database for pharmacovigilance. MATERIALS AND METHODS: All cases of KS worldwide until December 31, 2017, were included and analyzed in terms of age, sex, country, year of ADR, seriousness, clinical outcome, suspected drugs, administration, reported reaction, and -MedDRA terms...
March 22, 2019: International Journal of Clinical Pharmacology and Therapeutics
Kinga Sałat, Anna Furgała, Natalia Malikowska-Racia
Oxaliplatin is a third-generation, platinum-based derivative used to treat advanced colorectal cancer. Within the patient population on oxaliplatin therapy, a lower incidence of hematological adverse effects and gastrointestinal toxicity is noted, but severe neuropathic pain episodes characterized by increased cold and tactile hypersensitivity are present in ~95% of patients. This drug is also used to induce a rodent model of chemotherapy-induced peripheral neuropathy (CIPN)-related neuropathic pain which is widely used in the search for novel therapies for CIPN prevention and treatment...
March 22, 2019: Chemical Biology & Drug Design
Vikas Diwan, T Siddeshappa Srinivasa, K Yeltiwar Ramreddy, Vandita Agrawal, Sonika Nagdeve, Humera Parvez
Background: Pain is an inevitable outcome of any periodontal surgery. Controlling postoperative pain is of utmost importance so as to increase patient compliance. The present study aims to compare the degree of postoperative analgesia with the use of oral diclofenac sodium and transdermal diclofenac patch following periodontal flap surgery in patients with chronic periodontitis. Materials and Methods: A total of 20 patients requiring full mouth flap surgery were selected for this study...
January 2019: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
Jamal Naderi, Fariba Samani, Alireza Amooheidari, Shaghayegh Haghjooy Javanmard, Gelareh Vahabzadeh, Golnaz Vaseghi
Purpose: Breast and cervical cancers are the two most common cancers among women worldwide. Morphine is a potent analgesic for cancer pain, and radiation therapy is a conventional treatment for cancer. Unfortunately, the combined adjuvant cellular effects of morphine and ionizing radiation in cancer cells are largely unknown. Materials and Methods: In this study, we examined the effects of morphine and single radiation dose of 2 Gy on viability and survival fraction of human breast cancer cell line MDA-MB 231 and human cervical cancer cell line HeLa, by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and colony formation assays...
March 2019: Journal of Cancer Research and Therapeutics
Takanori Matsuura, Xu-Hui Li, Tao Chen, Min Zhuo
Matrix metalloproteinases (MMPs) have been suggested to contribute to long-term potentiation (LTP) and behavioral learning, and memory. In the dorsal horn of spinal cord, MMPs were reported to contribute to injury-related changes, and inhibitors of MMPs have been proposed as potential analgesics. However, it is unclear whether MMP inhibitors produce these effects by inhibiting the function of NMDA receptor (NMDAR), a key receptor for the induction of LTP. In the present study, we wanted to examine if MMP inhibitors affect NMDAR mediated excitatory postsynaptic currents (EPSCs) in the anterior cingulate cortex (ACC) of adult mice...
March 22, 2019: Molecular Pain
T Powell, M Nolan, G Yang, M Tam, D Metter, N S Gibran, G J Carrougher, T N Pham
The number of delirium days in hospitalized patients directly correlates with mortality and long-term cognitive dysfunction. Burn patients are at greater risk for delirium due to prolonged mechanical ventilation, high sedative and analgesic medication requirements, and the common need for multiple operations. Limited research exists on nurses' understanding and comfort using delirium screening tools and preventive interventions. A process improvement project was developed in a single, regional burn intensive care unit (BICU) with the goal of increasing RN staff awareness of delirium, delirium assessment, and preventive interventions...
March 21, 2019: Journal of Burn Care & Research: Official Publication of the American Burn Association
Shah Alam Siddiqui, Atiqur Rahman, M Oliur Rahman, Mohammad Ahsanul Akbar, Mohammad Ajmal Ali, Fahad M A Al-Hemaid, M S Elshikh, M Abul Farah
The aerial parts of extensively used ethnomedicinal plant Mikania cordata (Burm. f.) Robinson growing wild in Bangladesh were investigated to isolate and characterize compounds responsible for the bioactivities of the plant. In the present study, a new derivatives of betulinic acid, 16-hydroxy betulinic acid [3β,16-dihydroxy-lup-20(29)-en-28-oic] was isolated and the structure of the compound was determined by NMR spectroscopic means and comparing with available literature data. The isolated compound was then investigated for different pharmacological activities including antibacterial, antifungal, analgesic, anti-inflammatory and antipyretic potential employing different methods...
March 2019: Saudi Journal of Biological Sciences
S Stevens Negus
All preclinical procedures for analgesic drug discovery involve two components: 1) a "pain stimulus" (the principal independent variable), which is delivered to an experimental subject with the intention of producing a pain state; and 2) a "pain behavior" (the principal dependent variable), which is measured as evidence of that pain state. Candidate analgesics are then evaluated for their effectiveness to reduce the pain behavior, and results are used to prioritize drugs for advancement to clinical testing...
April 2019: Pharmacological Reviews
Minna Lindlöf, Antti Lindgren, Juho Paavola, Nelli Väntti, Mikael von Und Zu Fraunberg, Timo Koivisto, Juha E Jääskeläinen, Olli-Pekka Kämäräinen, Jukka Huttunen
BACKGROUND: The purpose of this population-based case-control study was to evaluate analgesic use after subarachnoid hemorrhage (SAH) caused by rupture of a saccular intracranial aneurysm (sIA). METHODS: The study consisted of 1,187 patients alive 12 months after an sIA-SAH admitted to Kuopio University Hospital (KUH) between 1995 and 2014. Three controls, matched with age, gender and birthplace, were included for each patient. Data on ruptured sIA cases admitted to KUH from a defined catchment population in Eastern Finland were obtained from the KUH intracranial aneurysm database...
March 18, 2019: World Neurosurgery
Liu Ji, Yongmei Chen, Huixia Wei, Hui Feng, Ruijie Cang, Di Yu, Xianyu Wang, Xingrui Gong, Mazhong Zhang
Dynorphin A is increased in neuropathic pain models. Activation of α7 n acetylcholine receptor (nAchR) reduces inflammation and pain. Whether activation of α7 nAchR affects dynorphin A release is unknown. The experiments evaluated the proinflammatory effect of dynorphin A in the spinal nerve ligation-induced neuropathic pain models and the effect of α7 nAchR activation on the dynorphin A content. α7 nAchR agonist, PHA-543613 and its antagonist, methyllycaconitine citrate were used and dynorphin A content was measured after spinal nerve ligation and in microglia cultures to test the analgesic mechanisms of α7 nAchR activation...
March 18, 2019: Brain Research
Masoud Seddighfar, Zahra Ghasemzadeh, Ameneh Rezayof
The aim of the present study was to determine the involvement of the VTA 5-HT1A receptors in analgesia induced by the co-administration of morphine and dextromethorphan (DM). Male Wistar rats were bilaterally cannulated in the VTA by the stereotaxic instrument. The tail-flick and formalin tests were performed to assess nociception in the acute and tonic pain conditions respectively. The present data indicated that intraperitoneal (i.p.) administration of morphine increased the tail-flick latency (1-4 mg/kg) and decreased the pain score of formalin test (2-8 mg/kg), showing an analgesic effect...
March 18, 2019: Brain Research
Ahmed M Abbas, Ebtehal Ragab, Nora H Abd Ellah, Ali Sabra, Shymaa S Ali, Ahmed Mohamed, Ali H Yosef
OBJECTIVE: Intrauterine contraceptive device (IUD) insertion-related pain presents a push beyond the decline of women to use IUD for family planning. We aimed to investigate the analgesic effect of glyceryl trinitrate cream (GTN) in reducing pain during IUD insertion. MATERIALS AND METHODS: We conducted a randomized double-blinded placebo-controlled study (NCT02708251, in a tertiary University hospital. Reproductive-aged women requesting Copper IUD for contraception were considered...
March 18, 2019: Journal of Gynecology Obstetrics and Human Reproduction
Fabrizio Monaco, Nora Di Tomasso, Giovanni Landoni, Pasquale Nardelli, Andrea Radinovic, Francesco Melillo, Giuseppe D'Angelo, Paolo Della Bella, Alberto Zangrillo, Patrizio Mazzone
OBJECTIVE: To identify reliable predictors of periprocedural intensive care unit (ICU) admission after transvenous lead extraction (LE) in a high-volume center. DESIGN: Retrospective observational study. SETTING: University tertiary-care hospital. PARTICIPANTS: All patients undergoing LE at San Raffaele Scientific Institute, Milan, Italy, from 2005 to 2015. INTERVENTIONS: LE procedures were performed in the electrophysiology laboratories with a cardiac operating room on standby between the end of the morning surgical case and before the start of the afternoon surgical case...
February 13, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Yu Takeda, Shigeo Fukunishi, Shoji Nishio, Shinichi Yoshiya, Kazuma Hashimoto, Yuka Simura
BACKGROUND: Postoperative pain is a significant concern of patients before surgery. Multimodal pain management is an effective method of pain control after major orthopedic surgery. Acetaminophen is the most commonly used analgesic for the management of pain. It was hypothesized that 1000 mg of intravenous acetaminophen (IA) dosed every 6 hours would significantly reduce the postoperative pain score at rest and the opioid consumption volume in patients who would undergo total hip arthroplasty (THA) when compared to a control group...
February 25, 2019: Journal of Arthroplasty
Thomas Weiser, Cornelia Schepers, Tobias Mück, Robert Lange
Rapid onset of analgesic action is linked with rapid absorption of analgesics (high maximum concentration [Cmax ] and short time to maximum concentration [tmax ]). After overnight fasting, ibuprofen lysinate reaches higher peak plasma levels (Cmax ) earlier than ibuprofen acid (tmax ) with comparable exposure (area under the plasma concentration-time curve [AUC]); however, subjects usually take ibuprofen with or within a short time of a meal. Therefore, pharmacokinetic (PK) studies under fed conditions may better characterize properties under real-life conditions...
March 21, 2019: Clinical Pharmacology in Drug Development
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