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pain in.therapeutic hypothermia

See Wan Tham, Li Li, Philip Effraim, Stephen Waxman
Inherited erythromelalgia (IEM) is a well-described pain disorder caused by mutations of sodium channel Nav1.7, a peripheral channel expressed within dorsal root ganglion and the sympathetic ganglion neurons. Clinically, IEM is characterised by paroxysmal attacks of severe pain, usually in the distal extremities, triggered by warmth or exercise. Pain is not adequately treated by existing pharmacological agents. Individuals with IEM classically cool their limbs for relief, in some cases resulting in tissue injury...
July 26, 2017: BMJ Case Reports
Claire Temple-Oberle, Melissa A Shea-Budgell, Mark Tan, John L Semple, Christiaan Schrag, Marcio Barreto, Phillip Blondeel, Jeremy Hamming, Joseph Dayan, Olle Ljungqvist
BACKGROUND: Enhanced recovery following surgery can be achieved through the introduction of evidence-based perioperative maneuvers. This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery and to provide evidence-based recommendations for an enhanced perioperative protocol. METHODS: A systematic review of meta-analyses, randomized controlled trials, and large prospective cohorts was conducted for each protocol element...
May 2017: Plastic and Reconstructive Surgery
Uttam Kumar Sarkar, Nilendu Sarma, Sambreeta Debbarma, Asok Kumar Mandal, Ashok Kumar Bala
INTRODUCTION: Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive potentially life-threatening condition, characterized by glucocorticoid deficiency, preserved aldosterone/renin secretion, and secondary rise in plasma adrenocorticotropic hormone level. This occurs due to either mutation in adrenocorticotropic receptor (25%, FGD Type-1) or in the MC2 receptor accessory protein (15%-20%). However, in about 50% patients, no identifiable mutations have been identified. Clinically, it manifests with weakness, fatigue, weight loss, anorexia, nausea, vomiting, diarrhea, abdominal pain, hypoglycemia, and hypothermia...
March 2017: Indian Journal of Dermatology
Lars Emil Larsen, Wouter Van Lysebettens, Charlotte Germonpré, Sofie Carrette, Sofie Daelemans, Mathieu Sprengers, Lisa Thyrion, Wytse Jan Wadman, Evelien Carrette, Jean Delbeke, Paul Boon, Kristl Vonck, Robrecht Raedt
Vagus nerve stimulation (VNS) is a widely used neuromodulation technique that is currently used or being investigated as therapy for a wide array of human diseases such as epilepsy, depression, Alzheimer's disease, tinnitus, inflammatory diseases, pain, heart failure and many others. Here, we report a pronounced decrease in brain and core temperature during VNS in freely moving rats. Two hours of rapid cycle VNS (7s on/18s off) decreased brain temperature by around [Formula: see text]C, while standard cycle VNS (30[Formula: see text]s on/300[Formula: see text]s off) was associated with a decrease of around [Formula: see text]C...
August 2017: International Journal of Neural Systems
Ting Zheng, Ting Zhang, Run Zhang, Zi-Long Wang, Zheng-Lan Han, Ning Li, Xu-Hui Li, Meng-Na Zhang, Biao Xu, Xiong-Li Yang, Quan Fang, Rui Wang
Hemopressin and related peptides have shown to function as the endogenous ligands or the regulator of cannabinoid receptors. Moreover, hemopressin and its truncated peptides were also reported to produce a slight modulatory effect on opioid system. In the present work, based on the amino acid sequence analyses of hemoglobin subunit α, rat VD-hemopressin(α) [(r)VD-Hpα] was predicted as a cannabinoid peptide derived from rat α-hemoglobin. Furthermore, (r)VD-Hpα was synthesized and characterized in a series of in vitro and in vivo assays...
December 16, 2016: Neuropeptides
Roberto Luigi Cazzato, Julien Garnon, Nitin Ramamurthy, Guillaume Koch, Georgia Tsoumakidou, Jean Caudrelier, Francesco Arrigoni, Luigi Zugaro, Antonio Barile, Carlo Masciocchi, Afshin Gangi
Percutaneous imaging-guided cryoablation (PICA) is a recently developed technique, which applies extreme hypothermia to destroy tumours under close imaging surveillance. It is minimally invasive, safe, repeatable, and does not interrupt or compromise other oncologic therapies. It presents several advantages over more established heat-based thermal ablation techniques (e.g. radiofrequency ablation; RFA) including intrinsic analgesic properties, superior monitoring capability on multi-modal imaging, ability to treat larger tumours, and preservation of tissue collagenous architecture...
December 2016: Medical Oncology
Joseph K Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
November 2016: Journal of Trauma and Acute Care Surgery
Alexa Craig, Christine James, Janelle Bainter, Francis L Lucas, Scott Evans, John Glazer
BACKGROUND: The traumatic experiences of parents of babies treated with therapeutic hypothermia (TH) have been described. No research has assessed neonatal intensive care unit (NICU) nurse experience in providing care to hypothermic babies and emotional support to their parents. PURPOSE: To assess NICU nurse attitudes to the provision of TH with respect to perceptions about baby pain/sedation, need for nurse and parent education, decision making about initiation of TH, and barriers to best care...
April 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Niina Aaltonen, Ewa Kedzierska, Jolanta Orzelska-Górka, Marko Lehtonen, Dina Navia-Paldanius, Hermina Jakupovic, Juha R Savinainen, Tapio Nevalainen, Jarmo T Laitinen, Teija Parkkari, Mikko Gynther
Monoacylglycerol lipase (MAGL) is a serine hydrolase that acts as a principal degradative enzyme for the endocannabinoid 2-arachidonoylglycerol (2-AG). In addition to terminating the signaling function of 2-AG, MAGL liberates arachidonic acid to be used as a primary source for neuroinflammatory prostaglandin synthesis in the brain. MAGL activity also contributes to cancer pathogenicity by producing precursors for tumor-promoting bioactive lipids. Pharmacological inhibitors of MAGL provide valuable tools for characterization of MAGL and 2-AG signaling pathways...
October 2016: Journal of Pharmacology and Experimental Therapeutics
Joseph Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide life-saving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
May 27, 2016: Journal of Trauma and Acute Care Surgery
Helene Korvenius Nedergaard, Hanne Irene Jensen, Jørgen T Lauridsen, Gisela Sjøgaard, Palle Toft
BACKGROUND: Critically ill patients rapidly loose much of their muscle mass and strength. This can be attributed to prolonged admission, prolonged mechanical ventilation and increased mortality, and it can have a negative impact on the degree of independence and quality of life. In the NONSEDA trial we randomize critically ill patients to non-sedation or sedation with a daily wake-up trial during mechanical ventilation in the intensive care unit. It has never been assessed whether non-sedation affects physical function...
July 23, 2015: Trials
Konrad H Schlick, Thomas M Hemmen, Patrick D Lyden
Meperidine is used for pain control and treatment of shivering. Concerns about neurotoxicity, particularly seizures, have led to efforts limiting meperidine use. We reviewed the body of evidence linking meperidine to seizures. We searched PubMed for the terms meperidine, normeperidine, pethidine, and norpethidine; each was combined with the terms: seizure, epilepsy, epileptogenic, toxicity, overdose, seizure threshold, and convulsion. Articles were assessed for relevance. Semiologies were reviewed to ascertain seizure likelihood...
December 2015: Therapeutic Hypothermia and Temperature Management
Bogna M Ignatowska-Jankowska, Gemma L Baillie, Steven Kinsey, Molly Crowe, Sudeshna Ghosh, Robert A Owens, Imad M Damaj, Justin Poklis, Jenny L Wiley, Matteo Zanda, Chiara Zanato, Iain R Greig, Aron H Lichtman, Ruth A Ross
The CB1 receptor represents a promising target for the treatment of several disorders including pain-related disease states. However, therapeutic applications of Δ(9)-tetrahydrocannabinol and other CB1 orthosteric receptor agonists remain limited because of psychoactive side effects. Positive allosteric modulators (PAMs) offer an alternative approach to enhance CB1 receptor function for therapeutic gain with the promise of reduced side effects. Here we describe the development of the novel synthetic CB1 PAM, 6-methyl-3-(2-nitro-1-(thiophen-2-yl)ethyl)-2-phenyl-1H-indole (ZCZ011), which augments the in vitro and in vivo pharmacological actions of the CB1 orthosteric agonists CP55,940 and N-arachidonoylethanolamine (AEA)...
December 2015: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Sudeshna Ghosh, Steven G Kinsey, Qing-Song Liu, Lenka Hruba, Lance R McMahon, Travis W Grim, Christina R Merritt, Laura E Wise, Rehab A Abdullah, Dana E Selley, Laura J Sim-Selley, Benjamin F Cravatt, Aron H Lichtman
Inhibition of fatty acid amide hydrolase (FAAH) or monoacylglycerol lipase (MAGL), the primary hydrolytic enzymes for the respective endocannabinoids N-arachidonoylethanolamine (AEA) and 2-arachidonylglycerol (2-AG), produces antinociception but with minimal cannabimimetic side effects. Although selective inhibitors of either enzyme often show partial efficacy in various nociceptive models, their combined blockade elicits augmented antinociceptive effects, but side effects emerge. Moreover, complete and prolonged MAGL blockade leads to cannabinoid receptor type 1 (CB1) receptor functional tolerance, which represents another challenge in this potential therapeutic strategy...
August 2015: Journal of Pharmacology and Experimental Therapeutics
Liting Deng, Benjamin L Cornett, Ken Mackie, Andrea G Hohmann
Cannabinoids suppress neuropathic pain through activation of cannabinoid CB1 and/or CB2 receptors; however, unwanted CB1-mediated cannabimimetic effects limit clinical use. We asked whether CP55,940 [(-)-3-[2-hydroxy-4-(1,1-dimethylheptyl)phenyl]-4-(3-hydroxypropyl)cyclohexanol], a potent cannabinoid that binds with similar affinity to CB1 and CB2 in vitro, produces functionally separable CB1- and CB2-mediated pharmacological effects in vivo. We evaluated antiallodynic effects, possible tolerance, and cannabimimetic effects (e...
July 2015: Molecular Pharmacology
Lise Fonsmark, Lars Hein, Helle Nibroe, Helle Bundgaard, Inge de Haas, Susanne Iversen, Thomas Strøm
Sedation of critically ill patients undergoing mechanical ventilation should be minimized or completely avoided. Only in selected situations is sedation indicated as first line therapy (increased intracranial pressure or therapeutic hypothermia). The critical care physicians primary objective should be to focus on the reversible causes of agitation, such as: pain, anxiety, delirium, dyspnea, withdrawal symptoms, sleep or gastrointestinal symptoms. If sedation is used a validated sedation scale is recommended...
April 2015: Danish Medical Journal
C M Keenan, M A Storr, G A Thakur, J T Wood, J Wager-Miller, A Straiker, M R Eno, S P Nikas, M Bashashati, H Hu, K Mackie, A Makriyannis, K A Sharkey
BACKGROUND AND PURPOSE: Cannabinoid (CB) ligands have been demonstrated to have utility as novel therapeutic agents for the treatment of pain, metabolic conditions and gastrointestinal (GI) disorders. However, many of these ligands are centrally active, which limits their usefulness. Here, we examine a unique novel covalent CB receptor ligand, AM841, to assess its potential for use in physiological and pathophysiological in vivo studies. EXPERIMENTAL APPROACH: The covalent nature of AM841 was determined in vitro using electrophysiological and receptor internalization studies on isolated cultured hippocampal neurons...
May 2015: British Journal of Pharmacology
Palle Toft, Hanne Tanghus Olsen, Helene Korvenius Jørgensen, Thomas Strøm, Helle Lykkeskov Nibro, Jacob Oxlund, Karl-Andre Wian, Lars Marius Ytrebø, Bjørn Anders Kroken, Michelle Chew
BACKGROUND: Through many years, the standard care has been to use continuous sedation of critically ill patients during mechanical ventilation. However, preliminary randomised clinical trials indicate that it is beneficial to reduce the sedation level. No randomised trial has been conducted comparing sedation with no sedation, a priori powered to have all-cause mortality as primary outcome.The objective is to assess the benefits and harms of non-sedation versus sedation with a daily wake-up trial in critically ill patients...
December 20, 2014: Trials
Guido Wassink, Christopher A Lear, Katherine C Gunn, Justin M Dean, Laura Bennet, Alistair J Gunn
Multiple randomized controlled trials have shown that prolonged, moderate cerebral hypothermia initiated within a few hours after severe hypoxia-ischemia and continued until resolution of the acute phase of delayed cell death reduces mortality and improves neurodevelopmental outcome in term infants. The challenge is now to find ways to further improve outcomes. In the present review, we critically examine the evidence that conventional analgesic, sedative, or anticonvulsant agents might improve outcomes, in relation to the known window of opportunity for effective protection with hypothermia...
April 2015: Seminars in Fetal & Neonatal Medicine
Carla Lobina, Mauro A M Carai, Barbara Loi, Gian Luigi Gessa, Antonella Riva, Walter Cabri, Giovanna Petrangolini, Paolo Morazzoni, Giancarlo Colombo
AIM: This study investigated the protective effect of a standardized extract of Panax ginseng on multiple cisplatin-induced 'sickness behaviors' (model of cancer-induced cachexia) in rats. MATERIALS & METHODS: Cisplatin was administered twice weekly (1-2 mg/kg, intraperitoneal) for 5 consecutive weeks. Panax ginseng extract (0, 25 and 50 mg/kg, intragastric) was administered daily over the 5-week period of cisplatin exposure. Malaise, bodyweight and temperature, pain sensitivity, and endurance running were recorded at baseline and at 5 weekly intervals...
May 2014: Future Oncology
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