Articles: cations.
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Central pain syndromes affect several million people worldwide. A 52-year-old woman had central pain manifest as burning pain from her left foot to the knee for 12 years after treatment for a medullary cavernoma diagnosed after a right-sided brainstem bleeding episode. ⋯ Her baseline pain stayed at 2/10 at 140 days with spikes only to 5/10, and no additional medications. Scrambler (Calmare) Therapy deserves further study in central pain.
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Sternotomy pain is a common complication after cardiac surgery. We present a 77-year-old patient with severe acute sternal pain after coronary artery bypass graft surgery who was successfully treated with a novel peripheral regional anesthetic technique, the pecto-intercostal fascial block. This interfascial plane block may represent an effective regional anesthetic component of a multimodal analgesic strategy for cardiac surgery patients who suffer from significant pain after a median sternotomy and are typically anticoagulated.
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Critical care medicine · Jun 2018
Multicenter Study Comparative StudyActivated Prothrombin Complex Concentrate Versus 4-Factor Prothrombin Complex Concentrate for Vitamin K-Antagonist Reversal.
To compare the international normalized ratio normalization efficacy of activated prothrombin complex concentrates and 4-factor prothrombin complex concentrates and to evaluate the thrombotic complications in patients treated with these products for warfarin-associated hemorrhage. ⋯ A low, fixed dose of activated prothrombin complex concentrate was as effective as standard dose 4-factor prothrombin complex concentrate for normalization of international normalized ratio. In addition, we did not see an increase in thrombotic events.
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In the eighth edition of the AJCC cancer staging classification, the T system for distal cholangiocarcinoma (DCC) has been revised from a layer-based to a depth-based approach. The aim of this study was to propose an optimal T classification using a measured depth in resectable DCC. ⋯ ITT is an accurate approach for depth assessment in DCC. The four-tier ITT classification with cut-off points of 1, 5 and 10 mm seems to be a better T system than those in the seventh and eighth editions of the AJCC classification.