Curēus
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Naltrexone is a semi-synthetic opioid that has competitive antagonist activity at mu opioid receptors. Naltrexone has proven to be efficacious in the treatment of alcohol and opioid dependence, and a long-acting injectable form of naltrexone was developed to overcome non-compliance. Therefore, injectable naltrexone has the potential to become an important medication for the treatment of opiate and alcohol dependence. ⋯ However, lung biopsy showed findings consistent with drug-induced eosinophilic pneumonitis. The patient's hypoxia resolved with steroid therapy. The patient was discharged with a course of oral steroids, albuterol inhaler, and outpatient pulmonology follow-up.
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Acute respiratory distress syndrome (ARDS) is a potentially fatal lung injury that can present with divergent underlying cause across cases. Current treatment options are limited by an incomplete understanding of the disease sequelae, undefined unifying pathology, and lack of reliable diagnostic tools. ARDS is defined as respiratory failure not caused by fluid overload or cardiac failure within one week of a known clinical insult with bilateral opacities on chest imaging, and diagnosis is based on these parameters. Increased understanding of the inflammatory cascade associated with ARDS progression shows promise for identifying potential diagnostic biomarkers and additional treatment options. Here, we review recent studies that point to the unifying inflammatory element(s) of the disease process and the use of agents that decrease inflammation as potentially powerful treatments for ARDS patients.
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Background The aim of our study was to evaluate the efficacy of Modified Stoppa approach for surgical treatment of acetabulum fractures by analyzing clinical and radiological outcomes. Also, we assess intraoperative and postoperative complications of fracture treated by using Modified Stoppa approach. Objectives To evaluate clinical outcomes of Modified Stoppa approach by using Merle d'Aubigne hip score. ⋯ In operative complications one patient developed an external iliac vein injury which was repaired by a vascular surgeon, one patient had a superficial infection for which debridement, regular dressing, and IV antibiotics given and resolve in one month, obturator nerve injury in one patient which was resolve in five to six months, lateral femoral cutaneous nerve injury in one patient which resolved within three months and one patient urinary bladder injury which was repaired by a general surgeon. Conclusion Our experience with Modified Stoppa approach for surgical treatment of acetabulum fracture in 30 patients is excellent and effective for better visualization to anterior column, quadrilateral plate, and up to sacroiliac joint. This approach provides better visibility of the fracture site which allows for good to an excellent reduction of fracture and fixation. Although Stoppa approach is cosmetic surgery in terms of scar size, there is less complication rate than the ilioinguinal approach.
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Background and aim The primary aim of the study was to compare the intubation characteristics and effectiveness of intubating laryngeal mask airway (ILMA) and Ambu® Aura-i™ as a conduit for facilitating fiberoptic-guided intubation. Methods Eighty patients were enrolled in the randomized-controlled hospital-based study. After inducing general anesthesia, an appropriately sized ILMA (group 1)/Ambu Aura-I (group 2) was placed. ⋯ Seventy-five percent (75%) in group 1 and 87.5% in group 2 were successfully inserted on the first attempt (𝑝 = 0.33). The time taken for the removal of the device was 11.87 +1.265 seconds in group 1 and 11.25±1.58 seconds in group 2 (P=0.054). Conclusion The Ambu Aura-i scores superiorly over ILMA in requiring less time for successful insertion on the basis of statistical analysis and hence appears to be a better independent ventilatory device.
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The novel coronavirus disease of 2019 (COVID-19) is caused by the binding of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to angiotensin-converting enzyme 2 (ACE2) receptors present on various locations such as the pulmonary alveolar epithelium and vascular endothelium. In COVID-19 patients, the interaction of SARS-CoV-2 with these receptors in the cerebral blood vessels has been attributed to stroke. Although the incidence of acute ischemic stroke is relatively low, ranging from 1% to 6%, the mortality associated with it is substantially high, reaching as high as 38%. ⋯ The patients were diagnosed with acute stroke as a complication of COVID-19 infection. We also provide an insight into the possible mechanisms responsible for the life-threatening complication. Physicians should have a low threshold for suspecting stroke in COVID-19 patients, and close observation should be kept on such patients particularly those with clinical evidence of traditional risk factors.