International journal of tissue reactions
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Randomized Controlled Trial Clinical Trial
Intraarticular injection of sodium hyaluronate plus steroid versus steroid in adhesive capsulitis of the shoulder.
To determine the efficacy of a combined treatment--namely hyaluronan and corticosteroid injection plus physical exercises in the management of established idiopathic capsulitis of the shoulder--30 consecutive subjects with adhesive capsulitis were selected for the study. The diagnosis of adhesive capsulitis was established on the basis of a clinical history of spontaneous shoulder pain, shoulder examination showing passive limitation in conformity with capsular pattern, cervical examination excluding significant dysfunction of this area, plain radiographs excluding other significant shoulder diseases, or sonographic examination showing capsule shrinkage in affected joint. The patients were randomly allocated to receive intraarticular injections of sodium hyaluronate (20 mg) plus steroid (20 mg triamcinolone acetonide) and physiotherapy or intraarticular injections of steroid (20 mg triamcinolone acetonide) alone and physiotherapy. ⋯ The results indicate an improvement of pain and joint motion after 6 months in all patients, especially in the patients treated with sodium hyaluronate. Intraarticular hyaluronan combined with triamcinolone acetonide and shoulder exercises may improve adhesive capsulitis. This drug possibly acts on shoulder tissue retraction by means of its influence on osmotic pressure and synovial fluid volume control.
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Cisplatin is a very effective antineoplastic drug. To date its major toxic dose-limiting effect is peripheral neuropathy. ⋯ Although the most striking pathological alterations were observed in the spinal ganglia neurons, initial axonal neuropathy was also demonstrated, whereas the spinal cord neurons were completely normal. Our findings further support the hypotheses that spinal ganglion neurons are the primary target of cisplatin peripheral neurotoxicity and that peripheral nerve damage is secondary to this neuronopathy.
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We have made a study of the use of Duoderm hydroactive sterile occlusive dressing on 10 patients for skin donor sites. Its therapeutic efficacy is evident and the dressing enhances the wound debridement and accelerates the re-epithelialization, with complete healing in 8.5 days on the average. ⋯ In addition, the new skin is softer, smoother and more homogeneous. Duoderm is also easy to use and is well tolerated by the patients.
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Randomized Controlled Trial Clinical Trial
Benzydamine for the prevention of pharyngo-laryngeal pathology following tracheal intubation.
A clinical study was carried out to assess the antiinflammatory effectiveness and related properties of this drug. It was performed double-blind in 40 adult patients (ASA I, and II) undergoing major otorhinolaryngological surgical procedures with tracheal intubation. ⋯ The following parameters were considered: physical examination, sensations referred from patient, cytologic examination, glottographic examination, and spectrographic examination. The results suggest that benzydamine applied locally at a concentration of 0.3% has therapeutic efficacy without local or systemic side-effects.
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The growing incidence of cancer pathology all over the world implies not only problems of prevention and cure, but also of pain control. Pain appears in more than 50% of cancer patients, mainly because analgesic opioids are not available or adequately administered. For this reason, the World Health Organization (WHO) has created a Collaborating Centre for Cancer Pain Relief at the Division of Pain Therapy of the National Cancer Institute, Milan. ⋯ Treatment is then either discontinued or changed to a following step because of side-effects (40%) or inefficacy (44%). The reduction in the use of non-narcotics corresponds to a successive increase in the use of opioids, particularly direct agonists. Through an adequate use of the analgesic ladder, pain can be relieved in the great majority of cancer patients.