Treatment with a combination of carbamazepine, a sodium channel blocker, and oxycodone, a mixed κ- and μ-opioid receptor agonist, may be useful in alleviating symptoms of trigeminal neuralgia.
Background:
Biofilm is a fundamental component in the pathogenesis of infections
related to the use of the central venous catheter (CVC,) which can represent an important health issue
in everyday practice of nursing and medical staff.
Objective:
The objective of the following review is to analyze the components of biofilm and their
role in catheter-related infection determinism in an evidencebased nursing perspective in such a way
as to give health professionals useful suggestions in the prevention and management of these
complications.
Methods:
The following databases were consulted for the bibliographic search: Medline, Scopus,
Science Direct.
Biofilm can be the cause of CVC extraction and can lead to serious haematogenic infectious
complications that can increase the morbidity and mortality of affected patients.
Results:
Updated pathophysiologic knowledge of biofilm formation and appropriate diagnostic
methodology are pivotal in understanding and detecting CVC-related infections.
Lock therapy appears to be a useful, preventive, and therapeutic aid in the management of CVCrelated
infections. New therapies attempting to stop bacterial adhesion on the materials used could
represent new frontiers for the prevention of CVC-related infections.
Conclusion:
The correct evidence-based nursing methods, based on the use of guidelines, provides
the opportunity to minimize the risks of infection through the implementation of a series of
preventive measures both during the CVC positioning phase and in the subsequent phase, for
example, during device management which is performed by medical and nursing staff.
Some papers reported the development of adverse drug reactions in patients with Down's syndrome during the treatment with antiepileptic drugs. However, at this time, no data have been published concerning the development of tremor in patients with Down's syndrome treated with sodium valproate. We report a 17-year-old man with epilepsy and Down's syndrome who experienced tremor during the treatment with a low dosage of sodium valproate. The Naranjo probability scale documented a possible association between tremor and sodium valproate. Sodium valproate was changed to lamotrigine with both a rapid improvement of tremor and an optimal control of symptoms. In conclusion we documented that sodium valproate is able to induce in a patient with epilepsy and Down's syndrome, the development of tremor probably through the decreased activity of GABAergic neurotrasmission; however, further studies may be performed in order to validate this observation.
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