European review for medical and pharmacological sciences
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Eur Rev Med Pharmacol Sci · Jan 2015
Case ReportsTreatment with icatibant in the management of drug induced angioedema.
Acute, drug-induced angioedema may not respond to standard therapies, because the pathogenetic mechanism that induces the pathology is not always mediated by histamine but, in certain instances, by bradykinin. A case of angioedema is reported here, in which allergic etiology was excluded by the non-response to antihistamines. Considering the clinical history (repeated use of drugs) and the ineffectiveness of standard therapy, it was decided to administer a beta2 receptor antagonist, icatibant. ⋯ The use of icatibant for the treatment of other types of angioedema (which can also be life-saving if the airway is involved) is off label. The off-label use of a drug is allowed in the absence of a viable alternative therapy, if there is scientific evidence in the literature and if the prescriber takes responsibility. The case here reported draws attention to this therapeutic problem and underlines the fact that a life-threatening emergency can justify the use of icatibant.
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Eur Rev Med Pharmacol Sci · Jan 2015
Outcomes of cardiopulmonary resuscitation in trauma patients in the Emergency Department.
We aimed to determine our performance and factors effecting outcomes in cardiopulmonary resuscitation (CPR) for the patients with trauma in the Emergency Department (ED). ⋯ Our results revealed that, when performed in the leadership of an ED specialist, more successful outcomes may be obtained in CPR in trauma patients. We also determined that use of atropine does not contribute to survival rate. As CPR prolonges, the success rate falls.
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Eur Rev Med Pharmacol Sci · Jan 2015
Randomized Controlled TrialEfficacy of type a botulinum toxin injections and infrared polarized light on treating chronic migraine.
To investigate the clinical value of the combination of ultrasound-and-hyponome-guided type A botulinum toxin injection and infrared polarized light on treating chronic migraine. ⋯ The combination of ultrasound-and-hyponome-guided type A botulinum toxin injection and infrared polarized light on treating chronic migraine demonstrated a significant clinical effect.
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Eur Rev Med Pharmacol Sci · Jan 2015
ReviewA look inside the association codeine-paracetamol: clinical pharmacology supports analgesic efficacy.
Acute and chronic pain often requires a multimodal approach. Combination therapy reduces the number of individual daily administrations and improves patient's compliance with the prescribed analgesic treatment. Despite the association codeine/paracetamol is one of the most widely used central analgesic, the exact mechanism of action, particularly of paracetamol, is still object of pharmacological research. ⋯ The addition of codeine to paracetamol significantly improves the analgesic action and reduces the number needed to treat (NNT) from 5 to 2.3-3.1. Recent warnings about the risk of its metabolism related to CYP450 and its genetic variability in general population should be mainly considered when the association is used in paediatric patients undergoing tonsillectomy and/or adenoidectomy procedures for obstructive sleep apnoea syndrome (OSAS). In adults, the association codeine/paracetamol has been shown to be effective and safe in different settings: acute pain, trauma patients, and chronic nociceptive pain.
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Eur Rev Med Pharmacol Sci · Jan 2015
ReviewSusac syndrome--clinical insight and strategies of therapy.
Susac syndrome is an uncommon autoimmune microangiopathy characterized mainly by neurological disorders and, to date, 304 clinical cases have been described. The background of this syndrome is an immune-mediated endotheliopathy that affects the microvasculature of the brain, retina, and inner ear resulting in encephalopathy, hearing loss, and branch retinal artery occlusions. ⋯ Magnetic resonance imaging, retinal fluorescein angiography, and audiography findings enable the diagnosis of this syndrome. In this review, we have demonstrated the epidemiology and pathology of Susac syndrome with detailed description of clinical signs, diagnostic procedures and therapeutic possibilities.