The Benefits of Botulinum Neurotoxin Treatment in a Multitude of Medical Conditions

Self Cite

Pain is a very important issue to take into account during hospitalization. Nefopam, a centrally acting analgesic, has a relative safety pharmacological profile with few and well-tolerated side effects, being used to treat acute or chronic pain. It inhibits the central reuptake of serotonin, norepinephrine and dopamine and modulates the sodium and calcium channels having only few contraindications. Nefopam can be part of balanced analgesia along with others non-opioids agents in order to reduce the opioid consumption and their complications, to control postoperative pain and to reduce the risk of neuropathic pain appearance. In order to avoid its adverse reactions, a slow infusion is always recommended. Nefopam has its role in preventing the shivering appearance during neuraxial or general anesthesia, can modulate the emergence agitation after nasal and maxillofacial surgery and can inhibit the sever hiccup during mechanical ventilation. Some cases about fatal overdoses are reported in the literature.

Section: Pharmacological Propertiesmentioning

confidence: 99%

Nefopam and its Role in Modulating Acute and Chronic Pain

Ţigliş¹,

Neagu²,

Elfara³

et al. 2018

Self Cite

“…Stent coating presents many improvements, such as the decrease of biofilm onset, inflammation and also in friction, and consequently lowering the risk of infections and an easier stent passage over a guidewire, too. Specific coatings may also be employed for drug eluting purpose [14]. Numerous strategies have been developed and tested, largely based upon the application of anti-adhesive and antimicrobial compounds.…”

Section: Stent Coatingmentioning

confidence: 99%

“…Most of these stents are placed for 2-3 weeks, but there are situations that require a longer period up to years. Usually patients with short-term stent placement present pain and discomfort during activity and urination [13], requiring analgesic medication or other types of procedures [14].…”

mentioning

confidence: 99%

Ureteral JJ Stent � Which One is Better?

Spînu¹,

Marcu²,

Socea³

et al. 2018

Ureteral stents represent a minimally invasive alternative to preserve urinary drainage whenever the ureter is damaged or is under a significant risk to be occluded due to extrinsic or intrinsic etiology, even due to iatrogenic cause. Ureteral obstruction caused by extrinsic compression is often associated with intra-abdominal neoplasms. The first-line therapy to relieve such obstructions is usually internal drainage with ureteral stents. Ureteral stents made of different materials have been designed to achieve the best drainage possible. In this study, we tried to compare different JJ stent materials � which are better and their pros and cons. The ideal stent that would combine perfect long-term efficacy with no stent-related morbidity is still lacking and stent usage is associated with several adverse effects that limit its value as a tool for long-term urinary drainage. Several new ideas on stent design, composition material and stent coating are currently under evaluation, and are trying to eliminate the drawbacks of ureteral stent usage. Almost every clinician is familiar with the drawbacks that are associated with stents, including infection, encrustation, pain and discomfort.

“…The main reason for increased serum levels of CK is a skeletal muscle lesion and it is possible to find elevation of CK after intramuscular injections and intense exercise [1,3], but usually significant increases of CK are found in major muscular or neuromuscular pathology as polymyositis, dermatomyositis, rhabdomyolysis, muscular dystrophies, drug-induced myopathies, seizures, malignant hyperthermia, malignant neuroleptic syndrome [7][8][9][10][11] in association with the increase of other enzymes as lactate dehydrogenase (LDH), aldolase or muscular components as myoglobin, being very problematic for patients with impaired renal function, especially if they need to go under surgery [12][13][14]. High levels are often encountered in case of bone fractures which needs extensive muscle and periosteum trauma and in aggressive tumors that have invaded the muscle tissue [15][16][17][18]. CK levels are useful not only for the diagnosis but also for monitoring these conditions.…”

mentioning

confidence: 99%

“…It is important to emphasize that persistent increases in CK in athletes after rest, even without symptoms, could indicate a muscular disease in early preclinical phase or muscular impairment function [3,19]. Amongst drug-induced muscular reactions, statin associated muscular symptoms (SAMS) are very frequent (7-29% of all treated patients) and a major cause of statin therapy non-adherence or discontinuation (65-75%) [8]. Due to the worldwide use of statins for prevention of cardiovascular events, the number of patients affected by SAMS is very high and continues to grow as statin therapy is extending, raising important issues in then subgroup of patients having chronic renal failure [20,21] but the majority of patients will have normal or slightly elevated CK levels [10,22].…”

mentioning

confidence: 99%

Macro Creatine Kinase (macro CK) in Clinical Practice

Bojincă¹,

Bojincă²,

Bălănescu³

et al. 2018

Creatine kinase (CK) is an important enzyme involved in energy metabolism. CK is found in the cytosol and mitochondria of various tissues, mainly those with increased energy necessities as skeletal muscle, cardiac muscle and brain, but also in visceral tissues. CK is a dimeric molecule composed of two identical or different subunits, type M - muscular and type B - brain. The combination of M and B subunits leads to formation of three isozymes: CK - MM found mainly in the skeletal muscle, CK - BB found mainly in the brain and CK - MB found mainly in the cardiac muscle, but also in small quantities in the skeletal muscle. The serum increase of different isozymes of CK is a consequence of cell disruption in various clinical situations like physical training, rhabdomyolysis, myositis, muscular dystrophy, myocardial infarction and others, CK being an important biomarker for this diseases. Macro CK is a complex of CK and immunoglobulin (macro CK type 1) or a polymer of mitochondrial CK (macro CK type 2) that induces false and persistent elevation of CK levels that could mislead the clinician. We present a review of the literature concerning the appearance and clinical significance of macro CK.