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pain in.therapeutic hypothermia

Alexa Craig, Christine James, Janelle Bainter, Francis L Lucas, Scott Evans, John Glazer, Donna Dowling
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...
October 18, 2016: 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...
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...
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
Mark A Tepper, Robert B Zurier, Sumner H Burstein
Ajulemic acid, a side-chain analog of Δ(8)-THC-11-oic acid, was designed as a potent therapeutic agent free of the psychotropic adverse effects typical of most cannabinoids. Subsequent studies of ajulemic acid have yielded widely divergent findings on the occurrence of these adverse effects. To help resolve these discrepancies, we have prepared highly purified ajulemic acid using a different synthetic method than previously reported in the literature and compared its cannabinoid receptor binding constants with those obtained using several other preparations from different sources...
July 1, 2014: Bioorganic & Medicinal Chemistry
Hallam M Gugelmann, David F Gaieski
A 34-year-old man with uncontrolled hypertension suffered a ventricular fibrillation cardiac arrest from an obstructive left anterior descending artery occlusion. He was defibrillated more than 10 times before achieving return of spontaneous circulation. He was comatose after his arrest and was treated with therapeutic hypothermia, and a bare metal stent was placed in his obstructed coronary artery with restoration of excellent postobstruction blood flow. His postarrest course was complicated by cardiogenic shock; prolonged ventilator-dependent respiratory failure requiring tracheostomy; tracheobronchitis, with cultures positive for methicillin-resistant Staphylococcus aureus (MRSA); and an extended period of agitation and delirium...
December 2013: Therapeutic Hypothermia and Temperature Management
J A Lowry, J T Brown
INTRODUCTION: The alpha-2 adrenergic (AA-2) receptor agonists and imidazolines are common exposures in the American Association of Poison Control Centers (AAPCC) National Poison Data System (NPDS). Although the interaction between the AA-2 receptor and imidazoline receptors has been extensively studied, it largely remains unknown to health-care professionals. This review describes these interactions and mechanisms by which agonists affect physiologic responses binding to these receptors...
June 2014: Clinical Toxicology
Joo Han Oh, Joon Yub Kim, Seok Won Chung, Ji Soon Park, Do Hun Kim, Sung Hoon Kim, Mi Ja Yun
PURPOSE: To compare the clinical efficacy of warmed irrigation fluid and room-temperature fluid in decreasing perioperative hypothermia during arthroscopic rotator cuff surgery. METHODS: In this prospective, randomized, comparative study, warmed (36°C) arthroscopic irrigation fluid (group W, n = 36) or room-temperature irrigation fluid (group RT, n = 36) was used without intraoperative warming devices during arthroscopic shoulder surgery in 72 patients. The serial core body temperature and the last and lowest core body temperatures were measured by use of an esophageal stethoscope with a thermometer and a digital tympanic thermometer at 15-minute intervals during the operation and recovery period, respectively...
February 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
Malka Yahalom, Nathan Roguin, Khaled Suleiman, Yoav Turgeman
The electrocardiogram (ECG) is the primary tool in the diagnosis of acute myocardial infarction (AMI). However, other clinical conditions, both cardiac and noncardiac originated pathologies, may result in ECG tracing of AMI. This may lead to an incorrect diagnosis, exposing the patients to unnecessary tests and potentially harmful therapeutic procedures. The aim of this report is to increase the still insufficient awareness of clinicians from multiple disciplines, regarding the different clinical syndromes, both cardiac and noncardiac, associated with ECG abnormalities mimicking AMI, to avoid unjustified thrombolytic therapy or intervention procedures...
June 2013: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
M C Neuffer, Y M Khalifa, M Moshirfar, M D Miffin
INTRODUCTION: Chilled saline is commonly used to irrigate the ocular surface after photorefractive keratectomy (PRK) and is often considered by the patients to be uncomfortable. Room temperature (non-chilled) saline may be a safe and less painful alternative. OBJECTIVES: To compare pain and visual outcomes after irrigating the ocular surface with chilled saline versus room temperature saline in alcohol assisted PRK. MATERIALS AND METHODS: In this prospective, single-masked, randomized, contralateral eye study, myopic eyes were treated with PRK...
July 2013: Nepalese Journal of Ophthalmology
Vuk Niković, Anton Laggner, Dejan Kojić
INTRODUCTION: Pulmonary embolism as a possible cause of acute heart failure is a potentially fatal condition that can cause death in all age groups. Patients successfully resuscitated after cardiac arrest have a high risk of increased mortality and their poor long-term outcome is often associated with severe neurological complications. CASE OUTLINE: This is a case report of a 67-year-old man after a successful cardiopulmonary resuscitation (CPR) which was followed by therapeutic hypothermia (TH)...
July 2013: Srpski Arhiv za Celokupno Lekarstvo
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