Medical science monitor : international medical journal of experimental and clinical research
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Fat embolization and fat embolism syndrome are poorly understood complications of skeletal trauma. Fat embolism syndrome is a clinical diagnosis, and patients typically present with a classic triad of petechial rash, pulmonary distress, and neurologic dysfunction. The incomplete form of the syndrome (i.e., cerebral fat embolism) is a more challenging clinical diagnosis in which brain magnetic resonance imaging may be a valuable tool. Fat embolism syndrome can be a life-threatening condition, but the latent form that occurs 24 to 72 hours after the trauma is frequently described as a self-limiting condition. ⋯ The pathogenesis and treatment options of fat embolism syndrome are reviewed based on available literature, and the usefulness of brain magnetic resonance imaging is discussed.
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This study aimed to decrease the massive problem of cataract-related blindness and visual disability in rural areas of Yemen and reach more visually impaired and blind people to provide them with an improved standard of visual rehabilitation. ⋯ The "eye camps" involved a comprehensive cooperative relief effort on a large scale to combat the widespread prevalence of cataract and chronic shortages of ophthalmic facilities and medical personnel as it affects residents of rural areas in Yemen. Until primary and secondary care facilities are optimal for cataract screening and surgery in Yemen, such eye camps are recommended to reduce the backlog of curable blindness resulting from cataract. This project will continue until enough eye hospitals are built in Yemen.
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Therapeutic drug monitoring (TDM) has been recognized as a useful guide in the clinical management of patients with epilepsy, in particular those on therapy with traditional antiepileptic drugs (AEDs). The demonstration of significant drug interactions and the introduction of the concept "therapeutic range" have also contributed to the view that monotherapy should be considered the "gold standard" in the treatment of epilepsy. Ten new AEDs have been approved and released to the market in the last fifteen years. ⋯ However, in selected cases or in response to a specific clinical question, a wise use of TDM of some new AEDs could represent a useful tool in the management of epileptic patients. Exceptions are thus represented by special conditions such as renal failure, dialysis, ascertainment of non-compliance, and pregnancy. For some new AEDs, TDM could be selectively and properly used in response to a single patient-specific pharmacokinetic or pharmacodynamic issue.
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Olfactory ensheathing cells (OECs) can remyelinate injured spinal cord and the peripheral nerve system, but little is known about its effect on the transected olfactory nerve. We investigated recovery of olfactory epithelium after transplanting allogeneic OECs in transected rat olfactory nerves. ⋯ Transplanted OECs may be used to treat transected olfactory nerves.
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Randomized Controlled Trial
Combined vs. Isoflurane/Fentanyl anesthesia for major abdominal surgery: Effects on hormones and hemodynamics.
Combination of epidural and general anesthesia (combined anesthesia) avoids the intraoperative use of intravenous analgesics and may reduce the surgical stress response during major abdominal surgery. This study examines the differences in intraoperative hemodynamic stability, cortisol levels and activity of cardiovascular hormones between combined anesthesia and isoflurane/fentanyl anesthesia. ⋯ Combined anesthesia reduces the intraoperative stress response, but moderate hemodynamic instability is relatively common and has to be compensated for by adequate volume replacement and vasopressor support.