Our results question the usefulness of calcitonin in chronic phantom limb pain and stress the potential interest of N-methyl-D-aspartate antagonists. Sensory assessments indicated that peripheral mechanisms are unlikely important determinants of phantom limb pain. Ketamine, but not calcitonin, affects central sensitization processes that are probably involved in the pathophysiology of phantom limb pain.
It is not possible to conclude from our study if gynaecological patients with pelvic pain will benefit from HBOT. The application of HBOT to selected patients may be justified, but further research with adequate sample size, as well as the timing of HBOT related to the development of LRTI, is required to establish the optimum patient selection.
The effects of large doses of methylprednisolone (MP) (30 mg per kg. b.w.) in patients with lung contusion following blunt chest trauma were studied in 10 patients selected at random and compared with 10 chest trauma patients receiving no steroids, but otherwise treated in the same way. All patients survived. Serious post-traumatic complications were reduced in the steroid group. All patients were followed with haemodynamic and metabolic observations for 6 weeks using Swan-Ganz flow directed thermodilution catheters. The most pronounced effect of MP was a significant reduction of pulmonary vascular resistance which may prevent right heart failure. The study demonstrates that MP should be given in sufficient doses in patients with respiratory insufficiency following blunt chest trauma.
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