Articles: function.
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Cutaneous allodynia (CA) is a characteristic of central sensitization, predicting migraine progression, and poor response to therapy. The present study aimed to find out the cerebral functional alterations related to the establishment of central sensitization in migraineurs using functional magnetic resonance imaging (fMRI). ⋯ The interictal dysfunction of pain processing pathway may be responsible for (at least relevant to) central sensitization in migraine patients, via abnormal modulations of nociceptive transmission.
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Minerva anestesiologica · Jun 2015
Molecular weight and molar substitution are more important in HES-induced renal impairment than concentration after hemorrhagic and septic shock.
Clinical studies have raised concerns about the safety of 6% hydroxyethylstarch (HES) 130/0.42, but the pathomechanisms of this renal impairment remain unknown. To evaluate the effects of different HES concentrations, molar substitutions and molecular weights in HES-induced renal impairment, we used a porcine two-hit model that combined haemorrhagic and septic shock. ⋯ In this porcine two-hit shock model, treatment with 0.9% NaCl, HES 130/0.42 or HES 200/0.5 led to a similar maintenance of haemodynamic values. Despite this similar maintenance of the haemodynamic values, volume replacement with 6% and 10% HES 200/0.5 led to an accumulation of HES, higher colloid osmotic pressure and significantly reduced renal function after haemorrhagic and septic shock. These facts support the presumption that not the concentration but the degree of substitution and the molecular weight play a decisive role in HES-induced renal impairment.
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Traumatic brain injury (TBI) can result in cerebral oedema and vascular changes resulting in an increase in intracranial pressure (ICP), which can lead to further secondary damage. Decompressive craniectomy (DC) is a surgical option in the management of ICP. We aimed to investigate outcomes of DC after TBI. ⋯ DC decreased ICP postoperatively. The IMPACT and APACHE II scores are good models for prediction of death and poor outcome at 6 months.
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More than 20 years have passed since the first clinical application of continuous renal replacement therapy (CRRT) in children. In that revolutionary era, before roller pumps and dialysis monitors for intensive care units were readily available, continuous arteriovenous hemofiltration was the most common treatment for critically ill children. ⋯ After 20 years, significant developments in critical care nephrology have taken place. Clinical and technical issues have both been addressed, and severe pediatric AKI can currently be managed with accurate and safe dialysis machines that will likely warrant outcome improvements over the following decade.