Introduction:Patients undergoing upper extremity fracture surgery (UEFS) commonly suffer from unbearable acute pain. Opioids remain the mainstay of moderate to severe pain alleviation, although there is a growing concern regarding the increasing trend in misuse and abuse. This study aimed to observe the safety and efficacy of dinalbuphine sebacate (DS), a novel extended-release analgesic, along with multimodal analgesia (MMA) for post-UEFS pain control.Methods: We retrospectively reviewed the records of patients undergoing UEFS between August 2020 and January 2021. Eligible patients were included and divided into two groups, depending on the analgesic regimen. In the DS group, 150 mg DS was administered intramuscularly at least 12 h pre-operatively, while in the conventional analgesia (CA) group, 40 mg parecoxib was given within 3 h before surgery. Intraoperative fentanyl administration was guided by the Analgesia Nociception Index System in both groups. For breakthrough pain, fentanyl was used as rescue medicine in the
Objective: The objective of this study was to evaluate the efficacy of intraoperative aortic balloon occlusion (IABO) during cesarean section for placenta accreta, increta or percreta. Materials and Methods: This was a retrospective case-control study of patients with surgically or pathologically confirmed placenta accreta, increta or percreta who were examined from 2013 to 2017. One hundred and two patients (60%) had aortic balloon catheters placed before cesarean section (balloon group), and the other patients did not undergo balloon placement (control group). Clinical records from 170 subjects were reviewed. Results: Forty-nine patients were diagnosed as having placenta accreta (28.8%), 98 patients had placenta increta (57.6%), and 23 patients had placenta percreta (13.6%). Considering all subjects, the patients in the balloon group had a significantly reduced median estimated blood loss (p < 0.01), rate of transfusion (p = 0.02), amount of packed red blood cells (PRBCs) (p = 0.02), and decrease in hemoglobin levels (p = 0.03). Nine (8.8%) patients had catheterization-related complications, including eight cases of arterial or venous thrombosis. When the data were analyzed separately according to the different forms of abnormal invasive placenta, no difference in these surgical outcomes was observed between the two groups for women with placenta accreta or placenta percreta; however, for women with placenta increta who underwent IABO, the authors observed significant reductions in the estimated blood loss (p < 0.01), the amount of transfused PRBCs (p = 0.01), the extent to which hemoglobin levels decreased after surgery (p = 0.01), and the incidence of cesarean hysterectomy (p = 0.04). Conclusions: Although IABO was efficacious in both reducing intraoperative hemorrhage and blood transfusion, and in preventing hysterectomy during cesarean section for placenta increta, it should only be used on the basis of an accurate antenatal diagnosis, as it has a high risk of thrombosis and a high cost; immediate cesarean hysterectomy still seems to be the optimal management for placenta percreta.
Dear Colleagues:Everyone working in the field of focused ultrasound has been intrigued and inspired by the therapeutic potential and promise of this exciting technology. While still at an early stage, our push to develop focused ultrasound applications is increasing in scope and intensity. To me, the best gauge of our progress is the 3rd International Symposium on Focused Ultrasound.What makes this year's symposium different from its predecessors is the inclusion of more presentations, more indications and more advances in R&D and commercialization. All signal that the pace of progress in our field is escalating.I hope that clinicians attending this year's symposium gain meaningful insight into the full range of applications that focused ultrasound can provide to them and, therefore, to their patients. After all, having patients live longer, healthier lives is the driving force in all of our work. From the Foundation ChairmanDear Colleagues:Welcome to the 3rd International Symposium on Focused Ultrasound. You are participating in the most extensive program we have hosted to date featuring more than 170 oral and poster presentations spotlighting the latest developments in our field. This represents more than a 50% increase compared to the 2010 symposium and reflects the accelerating progress being achieved by the focused ultrasound community.In keeping with the Foundation's intense patient-centric orientation, the program emphasizes the translational and clinical research that is moving focused ultrasound into the realm of patient care.The potential focused ultrasound to improve the quality of life and longevity for millions of people around the world with serious medical disorders has never been more apparent. Effective therapies to decrease death, disability and suffering are now on the horizon, no longer beyond it. But we still need to shorten the distance. We will do that through capitalfinancial and, more importantly, human capital.The number of focused ultrasound investigators is continuing to grow as evidenced by the applications received for the Young Investigator Travel Awards. In 2010, there were 11 applications; this year, there were 44. But in order to move focused ultrasound forward more rapidly, we need more human capital. The most expeditious way to achieve this is to leverage the people who are currently engaged.The symposium is an important vehicle for disseminating knowledge and sharing ideas, the most important role is to serve as an incubator to foster collaboration -collaboration being the ultimate force multiplier for human capital. Please take advantage of the opportunities to establish new partnerships and collaborations, particularly during the Tuesday evening poster session.Several special events are planned during the symposium, including keynote talks by Dean Kamen, one of the international leaders in medical device innovation and inventor of the Segway, at Sunday's opening reception and by John Grisham, best-selling author and Foundation board member, on Tuesday morning.The Focused U...
Background Although many hypotheses about the pathogenesis of trigeminal neuralgia have been developed, there is little discussion about the multiple recurrences of trigeminal neuralgia. Case presentation Here we report a patient with refractory multiple recurrent trigeminal neuralgia, in which we accordingly found that an increase in facial pain trigger points and a rapid movement of the upper limb extremity could trigger an onset of trigeminal neuralgia. We offer hypothesis on the multiple recurrences of trigeminal neuralgia by explaining the cause of multiple trigger points in this patient. Conclusions Given that central sensitization is involved in a number of mechanisms of pain development and is associated with some of the symptoms of trigeminal neuralgia. We hypothesized that central sensitization may have been involved in the disease development of this case of refractory trigeminal neuralgia, which led to the development of trigger point generalization and multiple recurrence after surgical treatments.
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