Neuroendocrinol Lett
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Neuroendocrinol Lett · Jan 2012
Comparative Study Clinical TrialThe influence of clonidine on oral ketamine-midazolam premedication in intellectually disabled patients indicated for dental procedures: double-blind comparison of two sedation regimes.
Dental procedures on intellectually disabled patients represent a clinical challenge. The oral administration of sedating drugs can remediate the problems with cooperation and enable the medical procedures to take place. Standard guidelines are lacking for oral sedation of the intellectually disabled. ⋯ Our study is the first to document that oral administration of ketamine and midazolam in low doses represents a safe and effective method of premedication in intellectually disabled patients indicated for dental procedures. Clonidine co-administration did not exert any substantial benefit and should be left out in this clinical setting.
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Neuroendocrinol Lett · Jan 2012
Clinical TrialIntermittent subcutaneous morphine regimen for postoperative pain management following abdominal hysterectomy regarding morphine- and beta-endorphin systemic concentrations.
Systemic β-endorphin, an endogenous opioid and stress hormone, has been demonstrated to correlate with the postoperative pain intensity, however its putative role as a postoperative pain biomarker has not been cleared. ⋯ Systemic β-endorphin is not an appropriate pain marker in postoperative gynaecologic patients.
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Neuroendocrinol Lett · Jan 2012
Case ReportsHypothalamic dysfunctions as a late consequence of surgical opening of the lamina terminalis. A controversial hypothesis.
Opening of the lamina terminalis is often used in surgery of the optico-chiasmatic region. Consequently, alteration of cerebral-spinal fluid (CSF) dynamics can occur after this manoeuvre, thus potentially translating into clinical complications. Herein, we describe 2 cases in which clinically relevant hypothalamic dysfunctions developed after few days opening of the lamina terminalis both patients showed mild to moderate preoperative hydrocephalus which improved postoperatively. ⋯ Our experience may suggest that hypothalamic dysfunctions should be reminded as a possible, although rare, complication following the opening of the lamina terminalis. This clinical condition, if not properly managed, may contribute to trigger severe life-threatening complications.
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Neuroendocrinol Lett · Jan 2012
The relationship between S100B protein serum levels, injury severity and Glasgow Outcome Scale values in children with CNS injuries.
The S100B protein subgroup is a thermolabile acidic calcium-binding protein, which was first described in association with the central nervous system. Destruction of nerve tissue results in S100B protein release from astrocytes and elevation of its levels in cerebrospinal fluid. If the blood-brain barrier is also damaged, S100B can pass into the systemic circulation and elevated blood levels of S100B can be detected. High S100B serum levels in patients with head injuries are predictive of possible development of secondary brain injury and may be related to the extent of permanent injury to the CNS . ⋯ Due to high variability in S100B protein serum levels in children (dependent on age and gender) no correlation between initial S100B levels and GOS was observed for our group of patients. Our results indicate that the rate of decrease of S100B protein levels back to normal values is more meaningful than its absolute value.
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Neuroendocrinol Lett · Jan 2012
Case ReportsNeuronavigation used for the transsphenoidal resection of a pituitary adenoma accompanied by a concha sphenoid sinus.
A concha non-pneumatized sphenoid is considered to be a contraindication for the transsphenoidal resection of a pituitary adenoma. Specifically, this anatomical variation makes it difficult to approach the sella turcica. However, in this report, an intra-operative navigational system was used as a guide to access the sella through the sphenoid sinus. This procedure was found to be both reasonable and safe.