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Although intrathecal analgesia is an effective option during labour, there is a need to establish sustainable and assured analgesia during the entire labour process. We aimed to assess the effect of adding dexmedetomidine, fentanyl or morphine to low-dose bupivacaine-dexamethasone for intrathecal labour analgesia in multiparous women.
The objective of this study was to improve the patient comfort and safety during procedures done under anaesthesia and sedation. The analgesia nociception index (ANI) noninvasively provides information on the nociception-antinociception balance, and it can be used to assess analgesia objectively. We aimed to compare the effects of analgesia management with conventional methods and with ANI monitoring on total opioid consumption, sedation and analgesia levels in patients who underwent colonoscopy using sedo-analgesia.
Hurricane Harvey left a path of destruction in its wake, resulting in over 100 deaths and damaging critical infrastructure. During a disaster, public health surveillance is necessary to track emerging illnesses and injuries, identify at-risk populations, and assess the effectiveness of response efforts. The Centers for Disease Control and Prevention (CDC) and American Red Cross collaborate on shelter surveillance to monitor the health of the sheltered population and help guide response efforts.
Pain-perceptual nociceptors (PPN) are essential sensory neurons that recognize harmful stimuli and can empower the human body to react appropriately and perceive precisely unusual or dangerous conditions in the real world. Furthermore, the sensitization-regulated nociceptors (SRN) can greatly assist pain-sensitive human to reduce pain sensation by normalizing hyperexcitable central neural activity. Therefore, the implementation of PPNs and SRNs in hardware using emerging nanoscale devices can greatly improve the efficiency of bionic medical machines by giving them different sensitivities to external stimuli according to different purposes. However, current most-normal organic/oxide transistors face a great challenge due to channel scaling, especially in the sub-10 nm channel technology. Here, a sub-10 nm indium-tin-oxide transistor with an ultrashort vertical channel as low as ≈3 nm, using sodium alginate bio-polymer electrolyte as gate dielectric, is demonstrated. This device can emulate important characteristics of PPN such as pain threshold, memory of prior injury, and pain sensitization/desensitization. Furthermore, the most intriguing character of SRN can be achieved by tuning the channel thickness. The proposed device can open new avenues for the fascinating applications of next-generation neuromorphic brain-like systems, such as bio-inspired electronic skins and humanoid robots.
Kounis syndrome is defined by the occurrence of an acute coronary syndrome (ACS) in the setting of an allergic, hypersensitivity or anaphylactic condition. Degranulation of mast cells and platelet activation leading to the release of multiple inflammatory mediators are thought to make the arterial circulation susceptible to acute cardiac events. It is an often underdiagnosed entity in the emergency setting, due to lack of awareness among emergency providers. Identifying Kounis syndrome is critical, since managing ACS differs from that of a classical acute myocardial infarction. We present the case of a 72-year old male patient with a history of stable coronary disease who presented to the emergency department with a diffuse pruritic rash and chest pain. Electrocardiogram showed ST elevation myocardial infarction. Urgent coronary angiography revealed total occlusion of the mid left anterior descending coronary artery which was treated with a drug eluting stent with an excellent outcome. The pruritic rash responded to treatment with intravenous corticosteroids and antihistamines; No allergens were identified. The patient's symptoms resolved and he had an uneventful hospitalization. The diagnosis of Kounis syndrome can complicate the management of acute allergic reactions. Special precautions should be taken by emergency physicians with regards to the administration of beta blockers, morphine and vasodilators, which may be detrimental in this setting.
Interacting with social robots, such as the robotic seal PARO, has been shown to improve mood and acute pain for people with dementia. Little attention has been paid to the effect of PARO on people with dementia and chronic pain.
The Colloid Cyst Risk Score (CCRS) was devised to identify symptomatic colloid cyst patients and stratify risk of hydrocephalus. The CCRS considers patient age, presence of headache, colloid cyst diameter, fluid-attenuated inversion recovery (FLAIR) hyperintensity, and location within the third ventricle.
How variations of treatment time affect the safety/efficacy of Gamma Knife (GK) radiosurgery is a matter of considerable debate. Due to the relative simplicity of treatment planning for trigeminal neuralgia (TN) this question has been addressed in a group of these patients. Using the concept of biologically effective dose (BED) the effect of the two key variables, dose and treatment time have been taken into account.