Lancet
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Comparative Study Clinical Trial Controlled Clinical Trial
A control, double-blind comparison of mepivacaine injection versus saline injection for myofascial pain.
In a double-blind study 28 patients with acute, localised muscle pain received four local injections of mepivacaine 0.5%, and 25 patients with the same type of pain received local injections of an equivalent volume of physiological saline. The group receiving saline tended to have more relief of pain, especially after the first injection. ⋯ The study therefore raises questions about the mechanism by which local injections into muscle relieves pain, since there is the possibility that a similar effect might also be achieved by merely inserting a needle into the trigger point. Physiological saline is considered to be a more appropriate fluid for injection therapy than local anaesthetics since it is less likely to produce side-effects.
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The metabolism of (U--14C) glucose and its incorporation into acetylcholine were determined in vitro in fresh cortical biopsy samples from patients with Alzheimer's disease and controls. Synthesis of 14C acetylcholine was significantly reduced (60% and 67% reduction under stimulated and resting conditions, respectively) without significant changes in the overall metabolism of glucose (as measured by 14CO2 production). ⋯ The changes in cholinergic markers reflected the severity of psychological defects. Acetylcholine synthesis was not reduced in biopsy samples from patients suffering from presenile dementia with no histological evidence of Alzheimer's disease.