Articles: function.
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Randomized Controlled Trial
Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA: a first-in-human and randomised clinical trial.
Spinal cord injury (SCI) causes neural disconnection and persistent neurological deficits, so axon sprouting and plasticity might promote recovery. Soluble Nogo-Receptor-Fc decoy (AXER-204) blocks inhibitors of axon growth and promotes recovery of motor function after SCI in animals. This first-in-human and randomised trial sought to determine primarily the safety and pharmacokinetics of AXER-204 in individuals with chronic SCI, and secondarily its effect on recovery. ⋯ Wings for Life Foundation, National Institute of Neurological Disorders and Stroke, National Center for Advancing Translational Sciences, National Institute on Drug Abuse, and ReNetX Bio.
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Randomized Controlled Trial
Effects of Relaxation-Focused Nursing Program in Women with Ovarian Cancer: A Randomized Controlled Trial.
Surgical treatment is a major cause of hospitalization in ovarian cancer. In this process, physical problems, such as pain and changes in respiratory functions, and psychological problems, such as anxiety and stress, may develop. ⋯ The program was more effective than usual nursing care in preoperative anxiety, pain, and level of knowledge. Although there was no difference between the care satisfaction scores of the patients, the reasons for care satisfaction were different in the program. Developing and implementing care that combines stress reduction interventions and preoperative education can improve the preoperative outcomes of patients.
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Comment Meta Analysis
In ischemic stroke, EVT improved 90-d function more than usual care across admission SBP levels.
Samuels N, van de Graaf RA, Mulder MJHL, et al; HERMES Collaborators. Admission systolic blood pressure and effect of endovascular treatment in patients with ischaemic stroke: an individual patient data meta-analysis. Lancet Neurol. 2023;22:312-319. 36931806.
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Mayo Clinic proceedings · Aug 2023
ReviewQuestioning the Right to Pain Relief and Its Role in the Opioid Epidemic.
The new discipline of palliative care helped to establish the right to pain relief at the end of life and the necessity of using opioids to achieve that goal. Professional pain organizations followed the United Nations' model for universal human rights in their declaration of a universal right to pain management. Both palliative care and pain medicine specialties worked to establish pain as a legitimate focus of medical treatment separate from its association with disease. ⋯ This understanding of opioids as having distinct and separable analgesic and addictive potential was challenged by the 1970s discovery of an endogenous opioid system, which integrates pain and reward functions to support survival. Our modern pain neurophysiology places the patient with pain in a passive position from which it makes sense to assert a right to pain relief. To prevent future opioid epidemics we need to abandon clinical outpatient use of pain intensity scores and redefine the medical necessity of pain treatment as less about the reduction of pain intensity and more about the capacity to pursue personally valued activities.
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This study aimed to identify the clinical usefulness of assessing nutritional status using validated tools for the indication of enteral nutrition for patients with incurable cancer in palliative care. ⋯ Using the modified Glasgow Prognostic Score to identify the existence and severity of CC, which is associated with function, has the potential to help clinical decision making concerning the indication of enteral nutrition in patients with incurable cancer receiving palliative care.