British journal of anaesthesia
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Comparative Study
Spinal cord stimulation in complex regional pain syndrome: cervical and lumbar devices are comparably effective.
Spinal cord stimulation (SCS) has been used since 1967 for the treatment of patients with chronic pain. However, long-term effects of this treatment have not been reported. The present study investigated the long-term effects of cervical and lumbar SCS in patients with complex regional pain syndrome type I. ⋯ SCS reduced the pain intensity and improves health status in the majority of the CRPS I patients in this study. There was no difference in pain relief and complications between cervical and lumbar SCS.
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Standardized scenarios can be used for performance assessments geared to the level of the learner. The purpose of this study was to validate checklists used for the assessments of medical students' performance using high-fidelity patient simulation. ⋯ Five scenarios developed for this study were shown to be valid when using the faculty criteria for expected performance level.
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Case Reports
Fatal streptococcal necrotizing fasciitis as a complication of axillary brachial plexus block.
A 74-yr-old diabetic woman developed necrotizing fasciitis of the right upper limb after axillary brachial plexus block for carpal tunnel decompression. Clinical signs included oedema, diffuse swelling and bullae; rapidly followed by toxic shock syndrome and multiorgan failure. ⋯ Delay in antibiotic and surgical treatment probably affected the outcome. Early diagnosis and treatment are essential to improve the outcome of streptococcal necrotizing fasciitis.