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https://www.readbyqxmd.com/read/28944129/endoscopic-assisted-ommaya-reservoir-placement-technical-note
#1
Jessica Lane, Brad E Zacharia
Ommaya reservoir placement has been an option for patients requiring cerebrospinal fluid (CSF) access since the 1960s. It is preferred to repeat lumbar punctures, both in terms of patient comfort and the consistency of intrathecal drug concentration. Technological developments have advanced the placement technique, allowing for better accuracy and reduced complications. Freehand placement was first augmented with pneumoencephalograms and intraoperative computerized tomography (CT), then with optical-based navigation, and finally by utilizing electromagnetic neuronavigation...
July 19, 2017: Curēus
https://www.readbyqxmd.com/read/28943940/leptomeningeal-metastasis-of-pulmonary-large-cell-neuroendocrine-carcinoma-a-case-report-and-review-of-the-literature
#2
Guozi Yang, Zhenyu Pan, Ning Ma, Limei Qu, Tingting Yuan, Xiaochuan Pang, Xu Yang, Lihua Dong, Shixin Liu
Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare and malignant form of lung cancer with a poor prognosis for patients. The common sites of metastases are the liver, adrenal glands, bone and brain. LCNEC rarely metastasizes to the small intestine, ovaries, tonsils, mandible, vulva or spine. To the best of our knowledge, there have been no reports of leptomeningeal metastasis of LCNEC to date. The present case report describes an unusual case of leptomeningeal metastasis from pulmonary LCNEC alongside a review of the literature...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28940900/successful-control-of-pain-from-malignant-psoas-syndrome-by-spinal-opioid-with-local-anesthetic-agents
#3
Takashi Yamaguchi, Katsuyuki Katayama, Mina Matsumoto, Yoshifumi Sato, Noriko Nakayama, Ko Hisahara
BACKGROUNDS: Malignant psoas syndrome (MPS) is a rare but distressing pain syndrome observed in advanced cancer patients. Pain due to MPS is often refractory to multi-modal analgesic treatment, including opioid analgesics. As only one case demonstrating the efficacy of neuraxial analgesia in managing pain due to MPS has been reported, its role in MPS remains uncertain. CASES: We present three cases demonstrating the successful management of pain due to MPS using spinal opioids with local anesthetic agents...
September 23, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28939014/novel-endomorphin-analogs-are-more-potent-and-longer-lasting-analgesics-in-neuropathic-postoperative-inflammatory-and-visceral-pain-relative-to-morphine
#4
Amy K Feehan, Jenny Morgenweck, Xing Zhang, Ariel Amgott-Kwan, James E Zadina
Activation of the mu-opioid receptor provides the gold standard for pain relief, but a majority of opioids used clinically have adverse effects that have contributed to an epidemic of overdose deaths. We recently characterized mu-opioid receptor selective endomorphin (EM) analogs that provide potent antinociception with reduction or absence of a number of side effects of traditionally prescribed opioids including abuse liability, respiratory depression, motor impairment, tolerance, and inflammation [91]. The current study explores the effectiveness of these EM analogs relative to morphine in four major pain models by both intrathecal and intravenous administration in male, Sprague-Dawley rats and male CD-1 mice...
September 19, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28935695/confirmed-efficacy-of-etoposide-and-dexamethasone-in-hlh-treatment-long-term-results-of-the-cooperative-hlh-2004-study
#5
Elisabet Bergsten, AnnaCarin Horne, Maurizio Aricó, Itziar Astigarraga, R Maarten Egeler, Alexandra H Filipovich, Eiichi Ishii, Gritta Janka, Stephan Ladisch, Kai Lehmberg, Kenneth L McClain, Milen Minkov, Scott Montgomery, Vasanta Nanduri, Diego Rosso, Jan-Inge Henter
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome comprising familial/genetic HLH (FHL) and secondary HLH. In the HLH-94 study, with an estimated 5-year probability of survival (pSu) of 54% (95% CI, 48-60%), systemic therapy included etoposide, dexamethasone and, from week nine, cyclosporine A (CSA). HSCT was indicated in patients with familial/genetic, relapsing, or severe and persistent disease. In HLH-2004, CSA was instead administered upfront, aiming to reduce pre-HSCT mortality and morbidity...
September 21, 2017: Blood
https://www.readbyqxmd.com/read/28931335/activation-of-erk-signaling-by-src-family-kinases-sfks-in-drg-neurons-contributes-to-hydrogen-peroxide-h2o2-induced-thermal-hyperalgesia
#6
Ajeet Kumar Singh, Manjula Vinayak
Concomitant generation of reactive oxygen species during tissue inflammation has been recognized as a major factor for development and maintenance of hyperalgesia, out of which H2O2 is the major player. However, molecular mechanism of H2O2 induced hyperalgesia is still obscure. The aim of present study is to analyze the mechanism of H2O2 induced hyperalgesia in rats. Intraplantar injection of H2O2 (5, 10 and 20 µmoles/paw) induced a significant thermal hyperalgesia in the hind paw, confirmed by increased c-Fos activity in dorsal horn of spinal cord...
September 21, 2017: Free Radical Research
https://www.readbyqxmd.com/read/28928629/proteomic-identification-of-an-upregulated-isoform-of-annexin-a3-in-the-spinal-cords-of-rats-in-a-neuropathic-pain-model
#7
Wangyuan Zou, Wei Xu, Zongbin Song, Tao Zhong, Yingqi Weng, Changsheng Huang, Maoyu Li, Chuanlei Zhang, Xianquan Zhan, Qulian Guo
Neuropathic pain (NP) is induced by nerve damage or a disturbance in the peripheral or central nervous systems. Nerve damage causes the activation of sensitizing mechanisms in the peripheral and central nervous systems, which induces transcriptional and post-transcriptional alterations in sensory nerves. However, the underlying mechanisms of NP remain elusive. In the study, Two-dimensional gel electrophoresis (2DGE)-based comparative proteomics identified 38 differential gel spots, and 15 differentially expressed proteins (DEPs) between the sham and the chronic constriction injury (CCI)-induced neuropathic pain rats...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28928571/dexmedetomidine-as-adjuvant-to-lower-doses-of-intrathecal-bupivacaine-for-lower-limb-orthopedic-surgeries
#8
Taznim Mohamed, Indu Susheela, Beena P Balakrishnan, Suvarna Kaniyil
BACKGROUND: Dexmedetomidine, an α2 adrenergic agonist, has been found to be a useful adjuvant to local anesthetics. It has been found to produce satisfactory block with lower doses of spinal bupivacaine. AIM: The aim of this study is to compare the difference in spinal block characteristics and hemodynamic effects of 7, 8, and 9 mg hyperbaric bupivacaine combined with 5 μg dexmedetomidine and to find out the optimum dose that would provide satisfactory block and hemodynamic stability for lower limb orthopedic surgeries...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928563/comparative-study-of-constant-dose-intrathecal-hypobaric-levobupivacaine-with-varying-baricities-in-lower-limb-surgeries
#9
K P Biji, M Sunil, K T Ramadas
BACKGROUND: Hypobaric spinal anesthesia is advantageous for unilateral lower extremity fractures as it obviates pain of lying on fractured limb for performing subarachnoid block. AIMS: This study compares block characteristics and complications of three different baricities of constant dose intrathecal hypobaric levobupivacaine to determine an optimum baricity. SETTINGS AND DESIGN: One-twenty American Society of Anesthesiologists Physical Status 1 and 2 patients aged 18-65 years undergoing unilateral lower limb surgeries were divided into three equal groups for this prospective cohort study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928559/a-comparative-study-between-intrathecal-isobaric-ropivacaine-0-75-plus-dexmedetomidine-and-isobaric-ropivacaine-0-75-plus-fentanyl-for-lower-limb-surgeries
#10
Prabhavathi Ravipati, G Anand Isaac, P Narasimha Reddy, Leela Krishna, T Supritha
BACKGROUND: Spinal anesthesia is used commonly intraoperatively. However, local anesthetics are associated with relatively short duration of action. A number of adjuvants have been used to prolong the postoperative analgesia. OBJECTIVES: To compare efficacy of dexmedetomidine and fentanyl when given intrathecally as an adjuvant to 2.5 ml of 0.75% isobaric ropivacaine. MATERIALS AND METHODS: Sixty selected patients were randomized to receive 2...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928553/comparison-of-intrathecal-clonidine-and-fentanyl-as-adjuvant-to-hyperbaric-bupivacaine-in-subarachnoid-block-for-lower-limb-orthopedic-surgery
#11
Sidharth Sraban Routray, Khageswar Raut, Amit Pradhan, Abhilash Dash, Mina Soren
BACKGROUND: Many studies are there using adjuvants such as clonidine and fentanyl with bupivacaine in the subarachnoid block for prolonging postoperative analgesia. However, literature is divided regarding the dosage and efficacy of both intrathecal adjuvants. Furthermore, these adjuvants have their own side effects. Hence, search for ideal intrathecal adjuvant between clonidine and fentanyl to bupivacaine goes on. AIM: The aim of the present study was to compare the effect of intrathecal clonidine and fentanyl as adjuvant to bupivacaine in the subarachnoid block for lower limb orthopedic surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928550/evaluating-the-efficacy-of-tramadol-as-an-adjuvant-to-intrathecal-isobaric-levobupivacaine-for-elective-infraumbilical-surgeries
#12
Dewan Roshan Singh, Hajer Mohamed, N Krishnaveni, Kusha Nag
BACKGROUND: Long-acting local anesthetics are used in subarachnoid block to increase the duration of anesthesia. Adjuvants are added to improve the duration of analgesia. SETTINGS: Randomized controlled trial was conducted in the Department of Anesthesiology in a tertiary care hospital. AIMS AND OBJECTIVES: The objective of this study was to evaluate the efficacy of low-dose tramadol as an intrathecal adjuvant to levobupivacaine in terms of duration of analgesia, onset of sensory blockade, onset of motor blockade, and duration of motor blockade...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928548/a-prospective-comparative-observational-study-of-clinical-efficacy-of-isobaric-ropivacaine-0-75-with-of-isobaric-bupivacaine-0-5-intrathecally-in-elective-inguinal-hernia-repair-surgeries
#13
Shivam Bipin Parekh, Suchita Shailesh Parikh, Harsha Patel, Malini Mehta
AIMS: To evaluate the efficacy of intrathecal isobaric Ropivacaine and its comparison with intrathecal isobaric Bupivacaine in elective inguinal hernia repair surgeries. SETTINGS AND DESIGN: A prospective, randomized study was conducted in a tertiary care hospital with 80 patients of ASA grade I-III undergoing elective inguinal hernia repair surgery under spinal anaesthesia. Ethical committee clearance and written consent taken. The patients were randomly divided into two equal groups to the Ropivicaine group (Group R) and to theBupivicaine group (Group B)...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28924009/site-specific-regulation-of-p2x7-receptor-function-in-microglia-gates-morphine-analgesic-tolerance
#14
Heather Leduc-Pessah, Nicholas L Weilinger, Churmy Y Fan, Nicole E Burma, Roger J Thompson, Tuan Trang
Tolerance to the analgesic effects of opioids is a major problem in chronic pain management. Microglia are implicated in opioid tolerance, but the core mechanisms regulating their response to opioids remain obscure. By selectively ablating microglia in the spinal cord using a saporin-conjugated antibody to Mac1, we demonstrate a causal role for microglia in the development, but not maintenance, of morphine tolerance in male rats. Increased P2X7 receptor (P2X7R) activity is a cardinal feature of microglial activation, and in this study we found that morphine potentiates P2X7R-mediated Ca(2+) responses in resident spinal microglia acutely isolated from morphine tolerant rats...
September 18, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28921601/is-2-hydroxypropyl-%C3%AE-cyclodextrin-a-suitable-carrier-for-central-administration-of-%C3%AE-9-tetrahydrocannabinol-preclinical-evidence
#15
R Agabio, F Sanna, C Lobina, M Monduzzi, V Nairi, F Cugia, S Mameli, G M Pisanu, G L Gessa, M R Melis
Preclinical Research Δ(9) -Tetrahydrocannabinol (THC) is a hydrophobic compound that has a potent antinociceptive effect in animals after intrathecal (IT) or intracerebroventricular (ICV) administration. The lack of a suitable solvent precludes its IT administration in humans. 2-Hydroxypropyl-β-cyclodextrin (HPβCD) increases the water solubility of hydrophobic drugs and is approved for IT administration in humans. To investigate whether HPβCD might be a suitable carrier for ICV administration of THC in rats, two formulations containing THC complexed with HPβCD (30 and 135 μg of THC per animal) and vehicle were administered to Wistar rats...
September 18, 2017: Drug Development Research
https://www.readbyqxmd.com/read/28920889/therapies-targeting-dna-and-rna-in-huntington-s-disease
#16
REVIEW
Edward J Wild, Sarah J Tabrizi
No disease-slowing treatment exists for Huntington's disease, but its monogenic inheritance makes it an appealing candidate for the development of therapies targeting processes close to its genetic cause. Huntington's disease is caused by CAG repeat expansions in the HTT gene, which encodes the huntingtin protein; development of therapies to target HTT transcription and the translation of its mRNA is therefore an area of intense investigation. Huntingtin-lowering strategies include antisense oligonucleotides and RNA interference targeting mRNA, and zinc finger transcriptional repressors and CRISPR-Cas9 methods aiming to reduce transcription by targeting DNA...
October 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28919982/effective-management-of-spasticity-and-impacts-on-weight-change-and-resting-energy-expenditure-in-a-female-with-spinal-cord-injury-a-case-report
#17
Amy N Nevin, Khanh Nguyen, Sridhar Atresh, Angela Vivanti, Ingrid J Hickman
INTRODUCTION: The impact of muscle spasticity on weight change and energy expenditure after spinal cord injury (SCI) is not well understood. CASE PRESENTATION: This case study reports changes to body weight and resting energy expenditure (REE) in a 36-year-old female (T3 AIS A SCI; 80 kg; body mass index=28 kg m(-)(2) at injury) requiring escalating therapies to manage severe spasticity. Body weight, spasticity medications and fasted REE (measured using indirect calorimetry, canopy hood) were recorded at 4, 16, 17, 20 and 44 months post injury...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28919816/cxcr4-antagonist-amd3100-elicits-analgesic-effect-and-restores-the-glyr%C3%AE-3-expression-against-neuropathic-pain
#18
Xiaoming Liu, Hongjun Liu, Lihua Dai, Bingjie Ma, Ke Ma
OBJECTIVE: Chemokine CXCL12 and its receptor CXCR4 have been reported to play a critical role in neurogenesis and neuronal differentiation. Recently, some reports have implicated this chemokine signaling in the pathogenesis of many kinds of pain. However, its role in neuropathic pain (NP) is still largely unclear. This study explored the distribution and function of CXCR4 in spinal cord (SC) dorsal horn (DH) in a rat L5 spinal nerve ligation (SNL) model. METHODS: Rats received repeated intrathecal injection of CXCR4 antagonist AMD3100...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28919568/robotic-stereotactic-assistance-rosa-utilization-for-minimally-invasive-placement-of-intraparenchymal-hematoma-and-intraventricular-catheters-case-report
#19
Nima Alan, Phillip Lee, Alp Ozpinar, Bradley A Gross, Brian T Jankowitz
BACKGROUND: In patients with supratentorial spontaneous intracerebral hemorrhage, intrahematomal catheter placement may allow for intra-clot thrombolysis and drainage. Robotic assistance may be used for the stereotactic placement of catheters. CASE DESCRIPTION: A 76-year-old male presented with altered mental status and left-sided weakness. Non-contrast CT head showed a right ganglionic intraparenchymal hemorrhage with resultant entrapment of the temporal horn. Using Robotic Stereotactic Assistance (ROSA), an intrahematomal and an intraventricular catheter were placed...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28918556/effects-of-pregabalin-on-postoperative-pain-after-hysterectomy-under-spinal-anesthesia-with-intrathecal-morphine-a-randomized-controlled-trial
#20
Taniga Kiatchai, Vimolluck Sanansilp, Namtip Triyasunant, Sasithorn Saengprateep, Paksiree Changkittirat, Vuthinun Achariyapota
PURPOSE: To determine if preoperative pregabalin could decrease 24-h postoperative morphine consumption after spinal anesthesia with intrathecal morphine compared with placebo. METHODS: A randomized, double-blind, controlled trial was performed in the tertiary care center. Patients aged between 18 and 65 years who were American Society of Anesthesiologists class I-II and scheduled for abdominal hysterectomy with or without salpingo-oophorectomy were randomly allocated to a placebo or a pregabalin group...
September 16, 2017: Journal of Anesthesia
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