Minerva anestesiologica
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Minerva anestesiologica · Jul 2018
Current evidence for central analgesic effects of NSAIDs: an overview of the literature.
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for a variety of painful conditions. Their peripheral anti-inflammatory effect due to inhibition of prostaglandin synthesis is well documented. In the late 1980's, animal data suggested for the first time that NSAIDs might have central effects as well. ⋯ Relevant mechanisms that underlie this central action involve spinal upregulation of the enzyme cyclooxygenase, increased spinal prostaglandin E2 production, modulation of inhibitory fast synaptic currents in lamina I and II of the dorsal horn, and glycine-dependent modulation of pain. Results from animal models are not yet sufficiently supported by human studies. This does not necessarily imply that the central effects of NSAIDs are irrelevant to human pain, but rather that methodological and regulatory barriers are the limiting step to translating findings from animal studies to human research protocols.
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Minerva anestesiologica · Jul 2018
Observational StudyIncidence and risk factors of ventilator-associated pneumonia in neonatal intensive care unit: a first French study.
Ventilator-associated pneumonia (VAP) is a severe intensive complication and remains under estimated in neonatal intensive care unit (NICU). Center for Disease Control defined criteria for adults and pediatrics without neonatal criteria. The objective of this article was to evaluate the rate, the risks factors and the outcome of neonates suffering from ventilator-associated pneumonia in a French NICU. ⋯ We describe the first French study on VAP in a neonatal population. Amongst nosocomial infections, VAP is a complication with severe consequences for NICU patients. Larger studies are needed to better define a diagnosis strategy and prevention bundle.