EXERCISES FOCUSED ON HARMONIZATION MERIDIAN PATHS IN PREVENTION BACK PAIN.

Back pain is one of the most common ailments that have plagued mankind since time immemorial. The frequency of spinal diseases is second only to seasonal viral upper respiratory infections. The period of the Covid 19 pandemic has expanded mandatory work from home - home office, limiting the mobility of the population and thereby increasing back pain due to muscle imbalance in the back area. Muscle imbalance can originate from incorrect, one-sided or long-term loading of the axial organ - the spine. If one adds to this the forcing of the position of the head and upper limbs, which is part of the work with the imaging unit, then it is not surprising that the prevalence of non-specific back pain is high and shifts to the lower age groups. Physiotherapy has a large number of special methods and procedures that can prevent back pain with regular exercises. It was during the Covid 19 pandemic that there was a massive increase in the use of distance methods aimed at practicing physical activity for back pain in the sense of pain therapy or its prevention. The paper describes meridian pathwas and exercises aimed at their harmonization and presents the partial results of the authors'pilot study, which determines the effect of exercises aimed at harmonizing meridian pathways on the perception of pain in non-specific back pain in a distance form.Copyright © 2022 TIGIS Spol. s.r.o.. All rights reserved.

ANALGESIA AND SEDATION OF MECHANICALLY VENTILATED PATIENTS IN THE INTENSIVE CARE - CURRENT APPROACH.

Analgesia and sedation are basic parts of the treatment in the intensive care. Nevertheless, deep sedation during mechanical ventilation has many adverse effects. In last decades the trend towards mild titrated sedation is seen. It enables early weaning from mechanical ventilation and shortening the stay in the intensive care setting and hospital. In this article pharmacology of main drugs used for analgesia/sedation nad strategy of sedation in mechanically ventilated patients are described. The last section of this article is dedicated to sedation of patients with acute respiratory distress syndrome of common"and COVID -19 etiology. These patients usually suffer from critical respiratory failure and agressive ventilatory support, prone positioning and other invasive techniques are needed. That is why deep sedation or even paralysis is sometimes necessary, but also in these patients lower sedation and weaning attempts should be tried as soon as possible.Copyright © 2022 TIGIS Spol. s.r.o.. All rights reserved.

Rebozo Technique Effectively Reduces Maternal Pain during Childbirth Stage 1 Active Phase

Background: Pain is the main complaint felt by mothers during childbirth. Pain management can be done with non-pharma-cological techniques, one of which is using the Rebozo technique. Objective(s): This study aimed to determine the effectiveness of the rebozo technique for active phase 1 labour pain in primipa-rous women. Method(s): The study used a quasi-experimental design with a pretest and posttest control group. An accidental sampling technique divided a sample of 30 people into control and intervention groups. The intervention group received Rebozo therapy, a therapy using a traditional cloth wrapped around the pelvis and buttocks with the mother kneeling, then shaking it slowly. The pain was measured using the Visual Analogue Scale (VAS), ranging from 0-10. Bivariate test using Wilcoxon. Result(s): The majority of respondents were aged 21-29 years (56.7%), had high school education (83.3%) and were house-wives (50%). The majority of the control group showed moderate pain (53.3%), while the intervention group showed severe (60%). The reduction in pain in the intervention group was more significant than in the control group (2.27 > 0.73). Both the control group and the intervention group showed p < 0.001. Conclusion(s): The Rebozo technique effectively reduces labour pain in the active phase of the first stage in primiparous women. This technique is easy and inexpensive, so it can be an option for non-pharmacological therapy to treat labour pain.Copyright © 2023 Japan University of Health Sciences.

Assessment of palliative approach in the pain management in endodontic emergencies during Covid-19 outbreak: Retrospective cohort study

Aim: During the coronavirus disease, a palliative approach was recommended for the management of endodontic emergencies. This retrospective cohort study was conducted to investigate the effectiveness of dexamethasone or ibuprofen-acetaminophen combination for pain management in endodontic emergencies. Material(s) and Method(s): One hundred and eight records of patients who presented to the emergency department with dental pain were evaluated retrospectively. Since interventional procedures were not performed during the pandemic period, Specific analgesics/antibiotics for the management of pain were preferred. A follow-up protocol with a questionnaire was developed to observe the effectiveness of palliative treatment and make changes if necessary. All participants received a questionnaire to rate the pain levels 6, 12, 18, 24, 48, and 72 hours after taking the drug. All data were collected from the patient file and assessed. After inclusion and exclusion criteria, 32 patients were included (n = 19, ibuprofen + acetaminophen;n = 13, dexamethasone). Data were analyzed using the chi-square test (P = 0.05). Result(s): In both groups, a significant decrease in pain was experienced immediately after medication and at 6, 12, and 18 hours, with no significant difference (P >.05). However, dexamethasone (Group II) resulted in lower pain levels than ibuprofen\acetaminophen (Group I) at 24 and 48 hours (P <.05) Discussion: Both dexamethasone and ibuprofen-acetaminophen can be good palliative choices in endodontic emergencies in pandemic conditions. However, at 24 and 48 hours, dexamethasone resulted in lower pain levels.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Observational study of peripheral skin temperature changes following spinal anaesthesia for caesarean delivery

Introduction: Effective spinal anaesthesia for caesarean delivery (CD) is assumed to cause bilateral sympathetic blockade with increased feet skin temperature due to vasodilatation [1]. There has been no published study of peripheral skin temperature measurements during spinal anaesthesia for CD. Our study investigated foot skin temperature changes as spinal anaesthesia was established. Method(s): A single centre, prospective observational study with ethics committee approval (IRAS No. 263967). With informed consent, 60 healthy parturients, 37-42 weeks' gestation with singleton pregnancy scheduled for category 4 CD with spinal anaesthesia were recruited. Standard spinal anaesthesia used 0.5% hyperbaric bupivacaine and diamorphine with IV Phenylephrine and fluids. Skin temperature was measured on the dorsum of both feet with Covidien Mon-a-Therm© skin thermistor sensors prior to intrathecal injection and every minute after until completion of surgery. Theatre room temperature and ambient temperature under surgical drapes were recorded. Two controls were recruited. Result(s): All participants had successful spinal anaesthesia. The Figure shows mean (95% CI) skin temperature changes of both feet of participants during spinal anaesthesia and for controls. The maximum rate of skin temperature increase occurred 5-12 minutes after spinal injection with temperature change plateauing after 30 mins. The mean temperature range was 5.54degreeC (min = 29.7degreeC;max = 35.2degreeC). Discussion(s): This study characterises for the first time the peripheral temperature changes in the feet that occur with sympathetic block after spinal anaesthesia in parturients. Increased bilateral foot skin temperatures occur within 10 minutes of spinal injection. This may be useful for determining successful spinal anaesthesia for CD in addition to other assessments [2]. The insights may be useful for assessing epidural analgesia. The study was supported by an OAA research grant. Data collected by ROAR group.Copyright © 2023 Elsevier Ltd

New definition of RIME: Mucocutaneous eruptions, bullous lesions and multi-mucosal involvement

Objectives: A 14-year-old female patient presents with marked haemorrhagic, adherent crusting of the upper and lower lip and enoral vesicles and erosions. Two weeks before, she had suffered from a respiratory tract infection. She did not take antibiotics but ibuprofen. One week later, she described a swelling and crusting of the upper and lower lips. Urogenital mucosa was also erosive. There was no ocular involvement. Another week later, cocard-like single lesions with partly central blister formation developed. A flaccid blister of 15 mm in diameter was detected in the left ear helix. In total, there was a limited cutaneous involvement of <10% BSA. The girl was admitted to the paediatric clinic. Method(s): Due to mucocutaneous eruptions, bullous lesions and multimucosal involvement, we assumed a Steven-Johnson syndrome or reactive infectious mucocutaneous eruption (RIME). Intravenous rehydration and prophylactic administration of cefotaxime and aciclovir were given. She was balanced and given analgesia with novalgin. The recent increased intake of ibuprofen was discontinued. Local therapy included mometasone cream and serasept dressings. During the inpatient stay, the general condition stabilised and the skin efflorescence's showed a clear regression. Result(s): The microbiological smears for COVID-19, HSV, VZV, mycoplasma, and chlamydia were negative. Discussion(s): As adult classifications for blistering severe cutaneous adverse reactions are limited applicable in children, Ramien et al. proposed revised paediatric-focused clinical criteria 2021. They leave traditional definitions of EEM, SJS and TEN. But they distinguish erythema multiforme (EM) for classic targets with/without mucosal involvement, RIME for cases with mucosal predominance and a respiratory infection trigger, and drug-induced epidermal necrolysis (DEN) for cases caused by medications. (Ramien BJD 2021) There are no current guidelines for RIME therapy. A reasonable management approach includes symptomatic therapy, treatment of identifiable infectious triggers (if possible), consulting urologists, ophthalmologists and gynaecologists (if necessary), immunosuppression, and psychological support. (Ramien ClinExpDermatol 2021).

ID: 215433 The History of Spinal Cord Stimulation to Treat Painful Diabetic Peripheral Neuropathy

Introduction: Diabetic peripheral neuropathy (DPN) is the most common neuropathic syndrome seen in patients with diabetes. Roughly 30% of the diabetes patient population1 experience painful DPN symptoms including bilateral stabbing or burning pain in addition to numbness in the feet and lower legs. Traditionally painful DPN symptoms have been treated with conventional medical management (CMM) including glycemic control, general risk factor management, as well as pharmaceutical agents. These treatment approaches are often unsuccessful in the long-term1. Spinal cord stimulation (SCS) has been demonstrated as an effective treatment for painful DPN of the lower extremities with multiple publications dating back to 1996 showing benefits of SCS for pain relief and improved Quality of Life (QoL) in DPN patients (Figure 1)2-18. Method(s): A systematic literature review of the robust body of evidence for SCS in the treatment of painful DPN was conducted. Publications were selected for inclusion by two independent reviewers using defined selection criteria. Additional relevant publications from outside the search dates were included. Result(s): SCS was first documented as an effective treatment for DPN in three single-arm studies published between 1996 and 20122,4,5, one of which was followed-up to thirty-six months18, and another to seven-years3. These studies paved the way for two RCTs published in 20146,7, one of which was followed-up to five-years in two publications8,10, and another7 was followed-up with analyses on QoL9 and an evaluation of the effects of burst SCS17. Two meta-analyses were published in 2020 and 202111,12. A post-hoc analysis of a multi-center single-arm study on high frequency (10kHz) SCS to treat DPN was published in 202013 and followed by an RCT published in 202114 with additional 1-year follow-up15,16. Collectively these studies demonstrate that SCS is an effective therapy for patients with painful DPN by reducing pain and increasing QoL for DPN patients (Figure 1). Conclusion(s): This review of a large body of evidence shows a decades-long history of the effectiveness of SCS for symptom relief in patients suffering from painful DPN. Future research on the effectiveness of new waveforms and novel methods of energy delivery to the spinal cord are needed. The study of outcomes in addition to pain relief is also needed, which may better illustrate the breadth of effects of SCS therapy on the underlying disease factors. Increasing awareness of the current evidence is essential to increasing therapy adoption by expanding payer support and influencing referring health care provider behavior. Disclosure: Eric Grigsby, MD: AE Mann Foundation: Consulting Fee: Self, Bioness Inc.: Consulting Fee: Self, Medallion Therapeutics: Consulting Fee: Self, Medtronic: Consulting Fee: Self, SPR Therapeutics: Consultant: Self, Tenex Health: Consultant: Self, Voyager Therapeutics: Consultant: Self, Xalud: Consulting Fee: Self, AE Mann Foundation: Consulting Fee: Self, Medallion Therapeutics: Consulting Fee: Self, Bioness Inc.: N/A: Self, Medallion Therapeutics: N/A: Self, SPR Therapeutics: N/A: Self, Abbott / St. Jude Medical: N/A: Self, Tenex: N/A: Self, Vertos: N/A: Self, Xalud: N/A: Self, AE Mann Foundation: Consulting Fee: Self, Bioness Inc.: Consulting Fee: Self, Medtronic, Inc.: N/A: Self, Collegium Pharmaceutical, Inc.: Trustee: Self, Flowonix Medical: Served on speakers' bureau: Self, Jazz Pharmaceuticals: Served on speakers' bureau: Self, Jazz Pharmaceuticals: Trustee: Self, Spinal Restoration, Inc.: Trustee: Self, Jazz Pharmaceuticals: N/A: Self, Alfred Mann Foundation: N/A: Self, Boston Scientific: N/A: Self, CNS Therapeutics: N/A: Self, Collegium Pharmaceutical, Inc.: N/A: Self, Flowonix Medical: N/A: Self, Jazz Pharmaceuticals: N/A: Self, Medtronic, Inc.: N/A: Self, Myoscience: N/A: Self, NeurAxon Inc.: N/A: Self, Spinal Restoration, Inc.: N/A: Self, St. Jude Medical, Inc.: N/A: Self, Abbott Laboratories: Consultant: Self, Alfred Mann Foundation: Consulting Fee: Self, Cervel Neurotech, Inc.: Consultant: Self, CNS Therapeutics: Consultant: Self, Covidien: Consultant: Self, Cumberland Pharmaceuticals, Inc.: Consultant: Self, Flowonix Medical: Consultant: Self, Jazz Pharmaceuticals: Consultant: Self, Mainstay Medical: Consultant: Self, Medtronic, Inc.: Consultant: Self, Myoscience: Consultant: Self, NeuroPhage Pharmaceuticals: Consultant: Self, Nevro Corp: Consultant: Self, Palyon: Consultant: Self, Spinal Modulation: Consultant: Self, SPR Therapeutics: Consultant: Self, St. Jude Medical, Inc.: Consultant: Self, Tenex Health, Inc.: Consultant: Self, VertiFlex Inc.: Consultant: Self, Vertos Medical, Inc.: Consultant: Self, Xalud Therapeutics, Inc.: Contracted Research: Self, Medtronic, Inc.: Served on speakers' bureau: Self, Flowonix Medical: Served on advisory board: Self, Medtronic, Inc.: N/A: Self, Jazz Pharmaceuticals: N/A: Self, Medtronic, Inc.: Ownership Interest: Own Stock, Stock Options, Future Stock Options: Self, Nevro Corp: Ownership Interest: Own Stock, Stock Options, Future Stock Options: Self, Rachel Slangen, PhD: None, Lisa Johanek, PhD: Medtronic: Salary/Employee: Self, Maddie LaRue, PHD: Medtronic: Employee:, Cecile de Vos, PhD: None, Melissa Murphy: Medtronic: Consulting Fee:, Relievant: Consulting Fee:Copyright © 2023

Characteristics of delirium and its association with sedation and in-hospital mortality in patients with COVID-19 on veno-venous extracorporeal membrane oxygenation.

Background: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) has been used in patients with COVID-19 acute respiratory distress syndrome (ARDS). We aim to assess the characteristics of delirium and describe its association with sedation and in-hospital mortality. Methods: We retrospectively reviewed adult patients on VV-ECMO for severe COVID-19 ARDS in the Johns Hopkins Hospital ECMO registry in 2020-2021. Delirium was assessed by the Confusion Assessment Method for the ICU (CAM-ICU) when patients scored-3 or above on the Richmond Agitation-Sedation Scale (RASS). Primary outcomes were delirium prevalence and duration in the proportion of days on VV-ECMO. Results: Of 47 patients (median age = 51), 6 were in a persistent coma and 40 of the remaining 41 patients (98%) had ICU delirium. Delirium in the survivors (n = 21) and non-survivors (n = 26) was first detected at a similar time point (VV-ECMO day 9.5(5,14) vs. 8.5(5,21), p = 0.56) with similar total delirium days on VV-ECMO (9.5[3.3, 16.8] vs. 9.0[4.3, 28.3] days, p = 0.43). Non-survivors had numerically lower RASS scores on VV-ECMO days (-3.72[-4.42, -2.96] vs. -3.10[-3.91, -2.21], p = 0.06) and significantly prolonged delirium-unassessable days on VV-ECMO with a RASS of -4/-5 (23.0[16.3, 38.3] vs. 17.0(6,23), p = 0.03), and total VV-ECMO days (44.5[20.5, 74.3] vs. 27.0[21, 38], p = 0.04). The proportion of delirium-present days correlated with RASS (r = 0.64, p < 0.001), the proportions of days on VV-ECMO with a neuromuscular blocker (r = -0.59, p = 0.001), and with delirium-unassessable exams (r = -0.69, p < 0.001) but not with overall ECMO duration (r = 0.01, p = 0.96). The average daily dosage of delirium-related medications on ECMO days did not differ significantly. On an exploratory multivariable logistic regression, the proportion of delirium days was not associated with mortality. Conclusion: Longer duration of delirium was associated with lighter sedation and shorter paralysis, but it did not discern in-hospital mortality. Future studies should evaluate analgosedation and paralytic strategies to optimize delirium, sedation level, and outcomes.

Headaches in patients with new coronavirus infection

Objective. To study clinical features of migraine in patients with coronavirus infection, as well as headache associated with Covid-19. Material and methods. The study design was cross-sectional. We used free open online source <<Google, Forms>>. Participants were recruited by publishing a survey in social networks of the South Ural State Medical University among students who recovered from mild coronavirus infection in December 2020. The questionnaire assessed the features of migraine and headache ac-companying Covid-19. Results. There were 98 respondents;63 people had Covid-19 associated headaches. Previous migraine was observed in 25 patients, 32 people had no previous headache. According to patient self-assessment, cephalalgia was the most unpleasant symptom of coronavirus infection in 15% of respondents. Headache associated with infection corresponded to migraine phenotype in patients with previous migraine much more often than in those who had not previous migraine. Most patients required analgesics to relieve headache regardless previous migraine. Effectiveness of therapy was low. Respondents without previous cephalalgia rated Covid-19 headache as the most unpleasant symptom due to its intensity, high frequency and poor pain relief effectiveness. Covid-19 headache intensity was significantly higher in 52% of patients with previous migraine compared to baseline cephalalgia. Higher incidence by 2 or more times was observed in 72% of patients. In 28% of respondents, there was aggravation of course of migraine with higher intensity, incidence and poor pain relief after infection. Conclusion. Headache is a typical and maladaptive symptom of mild coronavirus infection. A quarter of respondents with previous migraine experienced aggravation of course of primary cephalalgia after Covid-19.Copyright © 2021, Media Sphera Publishing Group. All rights reserved.

COVID-19 Critical and Intensive Care Medicine Essentials

This book provides healthcare professionals in Critical Care setting an easy consultation guide to fight against COVID-19. The book is divided into sections: Fundamentals of COVID-19, Pneumological critical care, Neurological manifestations, Cardiovascular manifestations, Renal manifestations, Haemostasis and coagulation, Other multi-organs involvement, Principles of therapy. Each section includes: · brief pathophysiology of COVID-19 (ventilation, neurological, cardiovascular, etc.);· principles of management (enriched with flowcharts and figures);· principles of therapy;· tips and key messages. Readers can find the most updated advices on how to face the ongoing pandemic: from principles of conventional oxygen therapy, assisted and invasive mechanical ventilation in critically ill COVID-19 patients to the complications sometimes underestimated. Tables and flowcharts provided are based on current knowledge in COVID-19 to help the clinician managing COVID-19 patients by a multiple-organs prospective. Written by international key opinion leaders of each field, the book represents a point of reference for all professionals involved in the management of COVID-19 pandemic. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

British Society for Rheumatology Annual Conference 2023 Abstracts

The proceedings contain 343 papers. The topics discussed include: implementation of a disease modifying anti-rheumatic drug blood monitoring software: 8 years of experience in a single center;effectiveness of colchicine among patients with COVID-19 infection: a randomized, open labelled, clinical trial;rheumatic autoimmune diseases following COVID-19 infection: an observational study in Iraqi Kurdistan region;COVID-19 in male elite Irish-based athletes at a national sports institute;the effects of a pain management program for patients with an inflammatory arthritis;a retrospective analysis of the effectiveness safety of platelet rich plasma injections in primary osteoarthritis in knee joint, in patients attending a tertiary care hospital, Sri Lanka;a cohort study;do proformas used in fracture liaison service appointments reflect national osteoporosis clinical standards? a content analysis;calcium pyrophosphate dihydrate crystal in operated rheumatoid arthritis of the knee;cardiac amyloidosis: a case series of 31 patients with a comprehensive literature review;scoping review for the application of center of pressure for patient or intervention assessment in rheumatoid conditions;and four SNPs associated with monocyte/macrophage cell lineage uniquely associated with CRPS-1 in discovery and replication cohorts and suggest predisposition to regional osteopenia and digit misperception.

Patient Experience of Remote Healthcare during the Pandemic in Rheumatoid Arthritis and Adult Juvenile Idiopathic Arthritis

Background/Aims COVID-19 challenged traditional care models and necessitated introduction of remote consultations. We wanted to understand the experiences of people with rheumatoid arthritis (RA)/adult juvenile idiopathic arthritis (AJIA) on accessing healthcare remotely, and how well people understood their condition and treatment. Methods This collaborative work between the National Rheumatoid Arthritis Society (NRAS) and clinicians in Oxford led to the development of an electronic questionnaire that was disseminated in July 2021 for four weeks through e-newsletters and all NRAS social media platforms. Those living in the UK with RA and AJIA aged 18 and over were eligible. Analyses of data were performed in Microsoft Excel and IBM SPSSv28. Results We analysed 316 responses. There was a middle-aged (ages 46 to 54, 54.1%, n=171), Caucasian (97.5%, n=306), female (92.4%, n=292) preponderance. Most had RA (93%, n=294) followed by another inflammatory arthritis (4.1%, n=13) and AJIA (2.8%, n=9). The majority had their condition for >10 years (43.4%, n=137) but some were diagnosed <12 months ago (3.2%, n=10). Two thirds of participants (66.5%, n=210) did not know their DAS28 score. Of the remaining third, the most commonly reported measure was moderate disease activity (12%, n=38). Those with higher self-reported DAS28 scores were using analgesia more regularly (p<0.01) but we found no difference in NSAID, DMARD or steroid use. Age did not influence steroid usage (p=0.35), but those who had their condition for longer used more steroids and regular analgesia. Only 33.9% (n=107) of responders felt their condition had been managed adequately in the pandemic, with more reporting poor status (40.8%, n=129) rather than good (16.8%, n=53). Those living in the South of England reported statistically better disease control than those from the North, despite having more virtual assessments (p=0.02). Travelling and fear of Covid appeared more important than consultation skills. Just over a fifth (20.3%, n=64) felt greater focus should be given to patient concerns. Of the 9.1% of patients (n=29) with a new diagnosis made during the pandemic, 24.1% (n=7) unable to book a GP appointment easily. Patients experienced a median symptom time of 4-10 weeks before consulting GPs. Once assessed, 31% (n=9) were referred immediately while the median time was 4-8 weeks. We found 58.6% (n=17) of patients received their diagnosis within their initial rheumatology consultation and 76.5% (n=13) of these started a DMARD immediately. Conclusion Despite a greater emphasis on patient education and PROMs influencing clinical decision-making, it is staggering that two-thirds did not know their DAS28 score. Analgesia and steroid use were common in patients with well-established disease which remains a concern. Accessing appointments was a significant barrier to patients and delays in care were experienced at every step in the NHS management pathways. Remote consultations need greater emphasis on patient concerns.

Systematic Investigation Of Cardiovascular Problems In Children And Adult With Covid-19 And Multiple Trauma In Icu Based On Radiology And Analgesia View

This study deals with the systematic investigation of cardiovascular problems in Covid-19 and multiple trauma patients hospitalized in special units, relying on radiology and analgesia stereotypes. Abnormal heart rhythm, which includes high heart rate, irregular heart rate and slow heart rate, can be one of the complications of Corona disease. Also, some of the drugs used for Corona may have side effects such as lowering the heart rate. For example, in one of the recent studies, after starting treatment with Remdesivir, some patients experienced a drop in heart rate. In this study, doctors used dopamine injections to stabilize the patient's heart rate during the 5-day period of Redemsivir treatment, and the patients' heart problems resolved spontaneously at the end of the treatment. Corona virus damages the heart in different ways. The formation of a blood clot is one of the serious complications of Corona, which in some cases leads to death. Its symptoms include severe pain in the chest (heart and lungs), as well as shortness of breath. If the infection caused by Corona disease is severe enough to damage the lungs, less oxygen reaches the heart, which can also reduce the delivery of nutrients to the heart. Therefore, the heart needs more oxygen. The lack of this oxygen and nutrients causes damage to the heart muscles, which is accompanied by pain. Among the other causes of heart pain during the Corona disease, we can mention the inflammation of the heart muscle (myocarditis) and the inner wall of the heart (pericarditis), which can be caused by viral infections. At first, scientists thought that this inflammation was caused by the direct attack of the Corona virus on the heart muscle, but with further research, it became clear that this condition is a result of the overreaction of the body's immune system to the infection caused by the virus and can Another reason for pain in the chest and heart and arrhythmia (irregular heartbeat). [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Annual advances of acupuncture research in 2022

This article reviews the major advances in acupuncture research in 2022, including clinical reports, basic research, and reviews. In terms of the type of literature, most of them are systematic reviews and clinical trials, while high-quality basic studies can also be found. The innovative inventions and researches in this field are of increasing quality and in a wide range of fields, acupuncture is attracting more and more attention in the international arena. In particular, some acupuncture combined sensors such as H2 -EC/SD co-therapy, precise positioning, and vivo monitoring of neurotransmitter has been used for oncological diseases and neuropathic pain. Acupuncture has been shown to be beneficial in the treatment of pain, stroke, psychiatric disorders, cancer, COVID-19 and others. Most of the studies show that acupuncture can play a positive role in various diseases and provide evidence for clinical applications and mechanism research.Copyright © 2023 By Author(s). Published by TMR Publishing Group Limited.

Regional Anesthesia for Anesthesia Technologists

The anesthesia technicians/technologists (ATs) have expanded coordinated efforts with physicians in the perioperative environment. They are acting vigorously for the setup, operation, and maintenance of the necessary equipment that the anesthesia team of today and the future will use to care for the patient. Several tasks can be performed efficiently by ATs such as set up adjustment with complex procedures, escorting patients, solving trouble shooting, and assisting with patient's monitoring. This chapter is dedicated to serve the current and prospective ATs awareness with regional anesthesia procedures. It dissects the preparation, equipment set up, different types of regional blocks, and explain management of consequences during performing the procedures. Recommendations for regional anesthesia techniques during COVID-19 crisis are discussed to provide safety for both patients and healthcare providers. We hope this chapter provides the adequate information for our ATs in their daily collaborative work. © Springer Nature Switzerland AG 2022.

Spinal Versus General Anesthesia for Spine Surgery During the COVID-19 Pandemic: A Case Series

Background: Hospitals are one of the primary resources for disease transmission, so many guidelines were published, and neuro-surgeons were advised to postpone elective spine surgeries during the COVID-19 pandemic. Objective(s): To avoid pulmonary complications and reduce the risk of spreading the virus and contracting the disease during the COVID-19 era, we operated a group of our patients under spinal anesthesia rather than general anesthesia. Method(s): We retrospectively analyzed all patients who underwent discectomy surgery for lumbar spinal disc herniation under SA between September 2020 and 2021. Result(s): Sixty-four patients diagnosed with lumbar disc herniation underwent lumbar discectomy with SA. All patients except three were male. The mean age was 44.52 +/- 7.95 years (28 to 64 years). The mean procedure time for SA was 10 minutes. The duration of the surgery was 40 to 90 minutes per each level of disc herniation. The mean blood loss was 350 cc (200 to 600 cc). The most common involved level was L4/L5 intervertebral disc (n = 40 patients;63.5%). The mean recovery time was 20 minutes. Only three patients requested more analgesics for relief of their pain postoperatively. All patients with discectomy were discharged a day after surgery, and in the case of fusion, two days after surgery. All the patients were followed up for six months, showing no recurrence symptoms, good pain relief, satisfaction with the surgery, and no bad memory of the surgery. Conclusion(s): Spinal anesthesia is a good alternative or even the main anesthesia route for patients with lumbar disc herniation. More studies are needed to elucidate the best candidate for SA in patients with lumbar pathology.Copyright © 2023, Author(s).

Quality of life of palliative care cancer patients during COVID-19 lockdown phase

Background: Coronavirus pandemic in 2019 led India to implement a complete lockdown except for essential services. Cancer patients faced hindrances in seeking medical help. This caused stress and worry, leading to reduced quality of life (QoL). This study evaluated QoL and pain management in palliative care cancer patients during the lockdown. Patients and Methods: This was a cross-sectional observational study at a tertiary cancer hospital, over one month period with convenience sampling. Participants included all who were unable to visit the palliative outpatient department during the lockdown during the COVID-19 pandemic. They were contacted telephonically and a valid QoL questionnaire was filled out. Disease, demographic details and pain were assessed. Result(s): A total of 51 were interviewed, 45% (n = 23) patients reported difficult access to medication during the lockdown;18 (35.3%) required morphine to alleviate pain and 6 (33.33%) faced difficulty in acquiring morphine tablets. QoL scores did not differ based on access to morphine (p = 0.648). Mean QoL scores were 12.7 +/- 3.76 and 15.0 +/- 3.60 amongst patients who did not have access to other medications and those who did have access, respectively (p = 0.03). Overall QoL FACT G7 mean score was 14 +/- 3.8. The variables NRS (pain intensity) and QoL scores were found to be negatively correlated (Pearson's Correlation Coefficient: r (49) = -0.69, p < 0.00001). Conclusion(s): Evaluation of QoL of palliative care cancer patients during global crises plays an important role in the assessment of patients' overall condition as well as to maintain a continuum of care.Copyright © Via Medica.