Articles: chronic.
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Randomized Controlled Trial
A Randomized Controlled Trial of ACE-inhibition for Skeletal Muscle Dysfunction in Chronic Obstructive Pulmonary Disease.
Skeletal muscle impairment is a recognized complication of COPD, predicting mortality in severe disease. Increasing evidence implicates the renin-angiotensin system in control of muscle phenotype. We hypothesized that angiotensin-converting enzyme (ACE) inhibition would improve quadriceps function and exercise performance in COPD. ⋯ This randomized controlled trial found that ACE inhibition, using fosinopril for 3 months, did not improve quadriceps function or exercise performance in patients with COPD with quadriceps weakness.
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To present the recent literature on chronic postsurgical pain in children. ⋯ The literature on the topic is sparse. Prospective studies, including clinical examination, quantitative sensory testing, and long-term follow-up, are needed to increase our knowledge about the prevalence, risk factors, and underlying mechanisms.
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Minerva anestesiologica · Oct 2014
ReviewPharmacological and clinical differences among transmucosal fentanyl formulations for the treatment of breakthrough cancer pain. A review article.
Breakthrough pain (BTP) is highly prevalent (59.2%) in chronic cancer patients and normally needs rescue treatments' with opioids when pain flares up. Transmucosal oral/nasal fentanyl formulations are commonly used in clinical practice. The different methods of release influence the pharmacokinetics and clinical properties of these formulations. ⋯ In parallel, we report the differences in delivery systems, bioavailability, maximum plasma concentration (Cmax), plasma half-life, and time to reach Cmax (tmax). Considerable variability emerged between formulations. This suggests some considerations on the choice of the fentanyl formulation in the light of the BTP features in each clinical case.
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Paediatric chronic pain patients are a heterogeneous group. Individuals respond differently to standardized treatment. ⋯ The patient subgroups that were established proved stable across samples. Depending on the subgroup classification, patients differed in changes of core outcomes. These results offer initial hints for the need for subgroup-specific treatment planning.
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Anesthesia and analgesia · Oct 2014
The Antihypersensitive and Anti-inflammatory Activities of a Benzofuranone Derivative in Different Experimental Models in Mice: The Importance of the Protein Kinase C Pathway.
Benzofuranone (BF1) was synthesized and its effects evaluated on mechanical hypersensitivity and paw edema models induced by different agents and on neuropathic pain induced by partial ligation of the sciatic nerve. An attempt was also made to elucidate the mechanism of action. ⋯ BF1 has dose-dependent antihypersensitive and antiinflammatory effects in both acute and chronic models of pain and inflammation, possibly mediated through interference with the PKC activation pathway. The easy and fast synthesis of this compound, low-cost, low-concentration-requirement, and once-daily-administration drug suggest it as a candidate for future clinical studies.