Articles: patients.
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Plasma Beta endorphin (BE) is an endogenous peptide opioid derived form pro-opiomelanocortin. Although the role of plasma BE in pain regulation is unclear, plasma BE levels have been reported to correlate inversely with pain levels in cancer pain. ⋯ Plasma BE levels increased with improved pain control in patients with upper abdominal gastrointestinal malignancies. Although the role of plasma BE in pain pathophysiology is unclear, it appears that pain relief per se, and not the analgesic technique, modulates plasma BE levels. This suggests that plasma BE levels may serve as an objective measure of cancer pain severity and corroborate the patient's report of pain relief.
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Intensive Care Unit (ICU) services are expensive, and therefore appropriate utilisation is imperative. Delayed discharges impact on the efficiency and effectiveness of ICU services. This study examines the prevalence and reasons for delayed discharge. ⋯ Improvement in bed management and discharge processes (the only factors directly controllable by the hospital) is essential to reduce delays in discharge from ICU. Reducing discharge delays would free up beds for other admissions; may result in a cost saving for the hospital through more efficient resource utilisation; and, ultimately, would benefit patients.
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Letter Randomized Controlled Trial Clinical Trial
Scrubs versus professional attire: ED patients are indifferent.
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This was a pilot study to test the potential effectiveness of intradiscal restorative injection therapy and compare with intradiscal electrothermal therapy (IDET). Thirty-five patients for intradiscal injection and seventy-four for IDET took part in the study. All patients had intractable chronic discogenic low back pain, confirmed by discogram study. ⋯ However, the duration of pain flare-up was notably shorter for restorative injections (8.6 days) than for IDET (33.1 days). Biochemical intradiscal restorative injections may be useful to reduce pain and disability in patients with chronic discogenic low back pain, and have clinically similar efficacy to IDET, but with improved cost-benefit ratio. The results of this study indicate that controlled random prospective comparative studies need to be performed to establish the efficacy of this treatment.
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To evaluate the pattern and flow of epidural contrast in fluoroscopically guided lumbar interlaminar steroid injections. ⋯ Thirty six percent of the injections observed in the study revealed ventral contrast flow. Bilateral contrast flow occurred in 16% of the injections. Caudad contrast flow is less than cephalad. The observed contrast flows need to be studied clinically to determine if this can affect clinical outcome.