Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health
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Hawaii J Med Public Health · Jun 2013
Randomized Controlled TrialThe importance of communication in the management of postoperative pain.
This study investigates the importance of communication in surgery and how delivering preoperative patient education can lead to better health outcomes postoperatively, via promoting tolerable pain scores and minimizing the use of narcotics after surgery. Patients who underwent outpatient surgery were randomly divided into groups to compare the pain scores of those who received preoperative patient education, the experimental group, and those who did not receive any form of patient education, the control group. Two weeks before surgery, the experimental group subjects received oral and written forms of patient education consisting of how the body responds to pain, and how endorphins cause natural analgesia. ⋯ Patients in both groups were offered and received gabapentin and celecoxib preoperatively for prophylaxis of postoperative pain unless they declined. The control groups were found to have average pain scores significantly greater (P <.05) than the experimental groups and also a significantly longer (P <.005) duration of pain. This study illustrates the power of patient education via oral, written and visual communication, which can serve as an effective means to minimize narcotic analgesia after surgery.
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Hawaii J Med Public Health · Jun 2013
ReviewThe role of eosinophils in angiostrongyliasis: multiple roles for a versatile cell?
Human infection with the rat lungworm, Angiostrongylus cantonensis, is characterized by a vigorous eosinophil response that gives the disease its name, eosinophilic meningitis. The actual role eosinophils play, both protective and destructive, in this infectious process is still largely a mystery. Research since 2002 has indicated that eosinophils are a multifaceted granulocyte that contributes to a wide range of physiological and pathological processes depending on their location and activation status. This article suggests an expanded role for eosinophils as both classic antiparasitic effector cells and as immune regulatory cells in eosinophilic meningitis caused by Angiostrongylus cantonensis.
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Hawaii J Med Public Health · Jun 2013
Angiostrongylus cantonensis and rat lungworm disease in Brazil.
The metastrongyloid nematode genus Angiostrongylus includes 18 species, two of which are relevant from a medical standpoint, Angiostrongylus costaricensis and Angiostrongylus cantonensis. The first was described from Costa Rica in 1971 and causes abdominal angiostrongyliasis in the Americas, including in Brazil. Angiostrongylus cantonensis, first described in 1935 from Canton, China, is the causative agent of eosinophilic meningitis. ⋯ In Brazil seven human cases have been reported since 2007 from the southeastern and northeastern regions. Epidemiological studies found infected specimens of Rattus norvegicus and Rattus rattus as well as many species of molluscs, including the giant African land snail, Achatina fulica, from various regions of Brazil. The spread of angiostrongyliasis is currently a matter of concern in Brazil.
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Hawaii J Med Public Health · Jun 2013
Biology, systematics, life cycle, and distribution of Angiostrongylus cantonensis, the cause of rat lungworm disease.
Angiostrongylus cantonensis is a metastrongyloid nematode in the family Angiostrongylidae. It is the cause of angiostrongyliasis (rat lungworm disease), which manifests as eosinophilic meningitis. First described in 1935 from rats in China, A. cantonensis was placed in the genus Parastrongylus in 1986, but most workers have not adopted this treatment. ⋯ The natural life cycle involves rats as the definitive host and snails or slugs as the intermediate host. Human infection, as accidental hosts, results in worms maturing in the brain, but dying there instead of moving back into the bloodstream, as in rats, thereby leading to eosinophilic meningitis. The disease is an emerging infectious disease; Angiostrongylus cantonensis continues to be reported in new regions beyond its native range.