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https://www.readbyqxmd.com/read/29028641/postoperative-care-after-tonsillectomy-what-s-the-evidence
#1
Patrick Carpenter, Daniel Hall, Jeremy D Meier
PURPOSE OF REVIEW: The purpose of this review is to evaluate the current literature regarding postoperative management after tonsillectomy in children. RECENT FINDINGS: Controversy remains regarding the ideal medication regimen to manage pain after tonsillectomy. Acetaminophen and ibuprofen are routinely used, although concerns of more severe postoperative hemorrhage with ibuprofen remain. Narcotics are prescribed commonly, but with extreme caution in children with severe obstructive sleep apnea...
October 11, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28946059/pregabalin-as-adjunct-in-a-multimodal-pain-therapy-after-traumatic-foot-amputation-a-case-report-of-a-4-year-old-girl
#2
Stephanie Wössner, Kirsten Weber, Anna C Steinbeck, Markus Oberhauser, Matthias Feuerecker
BACKGROUND AND PURPOSE: The purpose of this case report is to describe a multimodal pain therapeutic concept including the adjunct use of pregabalin in a 4.5 year-old child after forefoot amputation. Phantom limb pain and sensation is a complex pain syndrome that is difficult to treat and prevent. 70-75% of all children develop such a pain syndrome after amputation. We describe here a paediatric patient who underwent forefoot amputation following traumatic foot injury and received multimodal pain therapy including pregabalin...
September 22, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28926735/ketamine-metabolites-with-antidepressant-effects-fast-economical-and-eco-friendly-enantioselective-separation-based-on-supercritical-fluid-chromatography-sfc-and-single-quadrupole-ms-detection
#3
Georg M Fassauer, Robert Hofstetter, Mahmoud Hasan, Stefan Oswald, Christina Modeß, Werner Siegmund, Andreas Link
Increasing evidence accumulates that metabolites of the dissociative anesthetic ketamine contribute considerably to the biological effects of this drug and could be developed as next generation antidepressants, especially for acute treatment of patients with therapy-refractory major depression. Analytical methods for the simultaneous determination of the plethora of hydroxylated, dehydrogenated and/or demethylated compounds formed after administration of ketamine hydrochloride are a prerequisite for future clinical investigations and a deeper understanding of the individual role of the isomers of these metabolites...
September 8, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28925030/drug-repurposing-may-generate-novel-approaches-to-treating-depression
#4
REVIEW
Mohamed Elsaed Ebada
OBJECTIVES: The breakthrough advancements in scientific medical research have greatly improved our understanding of the pathogenesis of depression, encouraging drug discoverers to take a shorter path than ever through drug repurposing to generate new antidepressant medications. In addition to reduced noradrenergic and serotonergic neurotransmission in the brain, other coincidence features such as glutamate neurotoxicity, inflammation and/or cerebrovascular insufficiency are implicated in the pathogenesis of major depressive disorder and late-life depression...
September 18, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28902622/functional-interaction-between-n-methyl-d-aspartate-receptor-and-ascorbic-acid-during-neuropathic-pain-induced-by-chronic-constriction-injury-of-the-sciatic-nerve
#5
Sepideh Saffarpour, Farinaz Nasirinezhad
BACKGROUND: Neuropathic pain is a chronic pain condition, which is resistant to therapy. Ascorbate was released because of the activation of glutaminergic neurons. Due to the important role of N-methyl-D-aspartate (NMDA) receptors in the pathophysiology of neuropathic pain, this study investigated the analgesic efficacy of ascorbic acid (AA) in neuropathic pain condition and the role of NMDA receptors in this effect. METHODS: For this purpose, adult male rats were randomly allocated to experimental groups (n=8 in each group)...
September 13, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/28888802/yamamoto-new-scalp-acupuncture-for-postoperative-pain-management-in-cats-undergoing-ovariohysterectomy
#6
Matheus R Ribeiro, Carolina B de Carvalho, Ricardo H Z Pereira, Gabriel M Nicácio, Rejane B Brinholi, Renata N Cassu
OBJECTIVE: To evaluate the analgesic efficacy of Yamamoto New Scalp Acupuncture (YNSA) as an adjuvant for postoperative pain management in cats. STUDY DESIGN: Prospective, randomized, blinded, clinical study. ANIMALS: Twenty cats aged (mean ± standard deviation) 25 ± 9 months and weighing 2.7 ± 0.6 kg undergoing ovariohysterectomy. METHODS: The cats were sedated with intramuscular (IM) ketamine (5 mg kg(-1)), midazolam (0...
April 13, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28870222/general-anesthetics-protects-against-cardiac-arrest-induced-brain-injury-by-inhibiting-calcium-wave-propagation-in-zebrafish
#7
Dao-Jie Xu, Bin Wang, Xuan Zhao, Yi Zheng, Jiu-Lin Du, Ying-Wei Wang
Cardiac arrest is a leading cause of death and disability worldwide. Although many victims are initially resuscitated, they often suffer from serious brain injury, even leading to a "persistent vegetative state". Therefore, it is need to explore therapies which restore and protect brain function after cardiac arrest. In the present study, using Tg (HuC:GCaMP5) zebrafish as a model, we found the zebrafish brain generated a burst of Ca(2+) wave after cardiac arrest by in vivo time-lapse confocal imaging. The Ca(2+) wave was firstly initiated at hindbrain and then sequentially propagated to midbrain and telencephalon, the neuron displayed Ca(2+) overload after Ca(2+) wave propagation...
September 4, 2017: Molecular Brain
https://www.readbyqxmd.com/read/28861119/evaluation-of-a-multimodal-pain-therapy-concept-for-chronic-pain-after-total-knee-arthroplasty-a-pilot-study-in-21-patients
#8
Dirk Zajonz, Johannes K M Fakler, Anna-Judith Dahse, Fujiaoshou Junping Zhao, Melanie Edel, Christoph Josten, Andreas Roth
BACKGROUND: In spite of the improvement of many aspects around Total knee arthroplasty (TKA), there is still a group of 10% to 34% of patients who is not satisfied with the outcome. The therapy of chronic pain after TKA remains a medical challenge that requires an interdisciplinary therapy concept. The aim of this prospective pilot study was to evaluate the efficacy of a multimodal pain therapy in chronic complaints after TKA. METHODS: In a prospective cohort pilot study, we included patients with chronic pain after TKA who obtained in-patient care, especially multimodal pain therapy (MMPT), for at least 10 days...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28860873/effects-of-intravenous-ketamine-in-a-patient-with-post-treatment-lyme-disease-syndrome
#9
Ashraf F Hanna, Bishoy Abraham, Andrew Hanna, Adam J Smith
Post-treatment Lyme disease syndrome (PTLDS) is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapies. The patient commenced an experimental intravenous ketamine infusion therapy at the Florida Spine Institute (Clearwater, FL, USA) and achieved relief from her chronic pain, an improved quality of life, reduced depression and suicidal ideation, and reduced opioid consumption...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28860841/a-review-of-the-management-of-phantom-limb-pain-challenges-and-solutions
#10
REVIEW
Cliff Richardson, Jai Kulkarni
BACKGROUND: Phantom limb pain (PLP) occurs in 50% and 80% of amputees. Although it is often classified as a neuropathic pain, few of the large-scale trials of treatments for neuropathic pain included sufficient numbers of PLP sufferers to have confidence that they are effective in this condition. Many therapies have been administered to amputees with PLP over the years; however, as of yet, there appears to be no first-line treatment. OBJECTIVES: To comprehensively review the literature on treatment modalities for PLP and to identify the challenges currently faced by clinicians dealing with this pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28851279/intravenous-theophylline-is-the-most-effective-intervention-to-prolong-eeg-seizure-duration-in-patients-undergoing-electroconvulsive-therapy
#11
Alexander Tzabazis, Michaela E Wiernik, Jan Wielopolski, Wolfgang Sperling, Harald Ihmsen, Hubert J Schmitt, Tino Münster
BACKGROUND: Seizure duration in electroconvulsive therapy (ECT) is positively related with patients' outcome. This study sought to investigate the impact of anesthetic management on seizure duration, and the impact of selected drugs (theophylline, remifentanil, S-ketamine) on seizure duration. METHODS: Retrospective analysis of all patients undergoing ECT at our institution from January 2011 to April 2012 was performed based on electronic medical chart and review of existing quality improvement data...
August 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28838328/backing-into-the-future-pharmacological-approaches-to-the-management-of-resistant-depression
#12
P J Cowen
Pragmatic studies indicate that a substantial number of depressed patients do not remit with current first-line antidepressant treatments and after two failed treatment steps the chance of remission with subsequent therapies is around 15%. This paper focuses on current evidence for pharmacological treatments in resistant depression as well as possible future developments. For patients who have failed to respond to two antidepressant trials, augmentation with atypical antipsychotic drugs, specifically quetiapine and aripiprazole, has the best evidence for efficacy, though older treatments such as lithium and triiodothyronine still have utility...
November 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28835456/systematic-review-of-pharmacological-therapies-for-the-management-of-ischaemic-pain-in-patients-with-non-reconstructable-critical-limb-ischaemia
#13
REVIEW
Áine Ní Laoire, Fliss E M Murtagh
BACKGROUND: Critical limb ischaemia (CLI) is a severe manifestation of peripheral arterial disease, characterised by chronic ischaemic rest pain, ulcers or gangrene. Management of ischaemic pain is challenging in patients with no options for revascularisation and optimal pharmacological therapies have not been established. OBJECTIVES: To identify and evaluate the effectiveness of pharmacological therapies to treat ischaemic pain secondary to non-reconstructable CLI...
August 23, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28834750/synaptic-regulation-of-a-thalamocortical-circuit-controls-depression-related-behavior
#14
Oliver H Miller, Andreas Bruns, Imen Ben Ammar, Thomas Mueggler, Benjamin J Hall
The NMDA receptor (NMDAR) antagonist ketamine elicits a long-lasting antidepressant response in patients with treatment-resistant depression. Understanding how antagonism of NMDARs alters synapse and circuit function is pivotal to developing circuit-based therapies for depression. Using virally induced gene deletion, ex vivo optogenetic-assisted circuit analysis, and in vivo chemogenetics and fMRI, we assessed the role of NMDARs in the medial prefrontal cortex (mPFC) in controlling depression-related behavior in mice...
August 22, 2017: Cell Reports
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#15
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28802882/chronic-opioid-therapy-modifies-qst-changes-following-ketamine-infusion-in-chronic-pain-patients
#16
Dermot P Maher, Yi Zhang, Shihab Ahmed, Tina Doshi, Charlene Malarick, Kristin Stabach, Jianren Mao, Lucy Chen
The long-term effects of opioids on sensitization processes are believed to be mediated through the NDMA receptor. QST changes observed following a ketamine infusion have been previously described but the effect that chronic opioids will have is not known. The results of this prospective randomized factorial trial compared the thermal QST changes observed following a 0.05 mg/kg ketamine infusion or a saline placebo in chronic pain subjects who were either opioid-naïve or were chronically using opioids for chronic non-cancer pain are presented...
August 9, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28799954/effects-of-systemic-glutamatergic-manipulations-on-conditioned-eyeblink-responses-and-hyperarousal-in-a-rabbit-model-of-post-traumatic-stress-disorder
#17
Lauren B Burhans, Carrie A Smith-Bell, Bernard G Schreurs
Glutamatergic dysfunction is implicated in many neuropsychiatric conditions, including post-traumatic stress disorder (PTSD). Glutamate antagonists have shown some utility in treating PTSD symptoms, whereas glutamate agonists may facilitate cognitive behavioral therapy outcomes. We have developed an animal model of PTSD, based on conditioning of the rabbit's eyeblink response, that addresses two key features: conditioned responses (CRs) to cues associated with an aversive event and a form of conditioned hyperarousal referred to as conditioning-specific reflex modification (CRM)...
October 2017: Behavioural Pharmacology
https://www.readbyqxmd.com/read/28748374/alterations-in-amino-acid-levels-in-mouse-brain-regions-after-adjunctive-treatment-of-brexpiprazole-with-fluoxetine-comparison-with-r-ketamine
#18
Min Ma, Qian Ren, Yuko Fujita, Chun Yang, Chao Dong, Yuta Ohgi, Takashi Futamura, Kenji Hashimoto
RATIONALE: Brexpiprazole, a serotonin-dopamine activity modulator, is approved in the USA as an adjunctive therapy to antidepressants for treating major depressive disorders. Similar to the N-methyl-D-aspartate receptor (NMDAR) antagonist ketamine, the combination of brexpiprazole and fluoxetine has demonstrated antidepressant-like effects in animal models of depression. OBJECTIVES: The present study was conducted to examine whether the combination of brexpiprazole and fluoxetine could affect the tissue levels of amino acids [glutamate, glutamine, γ-aminobutyric acid (GABA), D-serine, L-serine, and glycine] that are associated with NMDAR neurotransmission...
July 26, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28724494/pharmacokinetics-of-a-novel-transdermal-fentanyl-solution-in-rhesus-macaques-macaca-mulatta
#19
Gregory W Salyards, Marie-Josee Lemoy, Heather K Knych, Ashley E Hill, Kari L Christe
Rhesus macaques (Macaca mulatta) are the most commonly used NHP biomedical model and experience both research and clinical procedures requiring analgesia. Opioids are a mainstay of analgesic therapy. A novel, transdermal fentanyl solution (TFS) has been developed as a long-acting, single-administration topical opioid and was reported to provide at least 4 d of effective plasma concentrations in beagles (Canis familiaris). To evaluate the pharmacokinetic profile of TFS in healthy adult rhesus macaques, we used a 2-period, 2-treatment crossover study of a single topical administration of 1...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#20
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
September 2017: Paediatric Anaesthesia
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