From mechanisms to management: translating the neuropathic pain consensus recommendations into clinical practice.
Adult; Female; Humans; Middle Aged; Aged; Chronic Disease; Inflammation; Risk Factors; Evidence-Based Medicine; Practice Guidelines as Topic; Patient Selection; Acute Disease; Analgesics/therapeutic use; Patient Education as Topic; *Pain/diagnosis/etiology/physiopathology; Anticonvulsants/therapeutic use; Nervous System Diseases/*complications; Nurse Practitioners; Pain Management; Anesthetics; Drug Therapy; Combination; Antidepressive Agents; Local/therapeutic use; Tricyclic/therapeutic use
Chronic neuropathic pain poses a treatment challenge, and is associated with significant psychologic distress, physical disability, and impaired functioning, which impact the activities of daily living. Efforts to provide relief are often inadequate and/or require polypharmacy. This has spurred interest among researchers and clinicians alike to develop early, intensive treatments that target the molecular and cellular mechanisms involved in pain transduction, transmission, and modulation, or ideally, that prevent neuropathic pain from occurring in the first place. Currently, researchers are attempting to capitalize on our understanding of neuropathic pain pathophysiology to develop drugs that interrupt distinct activities involved in its perpetuation. In this regard, several potential agents (eg, NMDA and AMPA/kainate antagonists) are in phase 2 and 3 clinical trials. In the interim, evolving data and evidence-based neuropathic treatment recommendations provide guidance for selecting first- and second-line medications that alone or in combination offer acceptable neuropathic pain control and allow clinicians to bridge the gap between current knowledge and its application in the clinical setting. Hopefully, as basic and clinical science progresses, further treatment advances and management tools will be found to improve the care of patients who live with neuropathic pain.
Chevlen Eric; Davis Pamela Stitzlein; Rhiner Michelle
Journal of the American Academy of Nurse Practitioners
2005
2005-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Rhodotorula minuta: an unusual fungal infection in hip-joint prosthesis.
Female; Humans; Aged; Antifungal Agents/therapeutic use; Anti-Infective Agents; *Mycoses/drug therapy; *Rhodotorula; Amphotericin B/therapeutic use; Bacitracin/therapeutic use; Hip Prosthesis/*adverse effects; Prosthesis-Related Infections/*microbiology; Drug Therapy; Combination; Local/therapeutic use
Fungal infections of total joint arthroplasty are uncommon complications, and most cases have been associated with Candida species. In this article, we present a case in which a total hip arthroplasty was infected with Rhodotorula minuta. Intraoperative gram stain showed yeast formsand led to early detection and immediate treatment with amphotericin B and bacitracin. Successful reimplantation was performed 12 months later. To our knowledge, this is the first reported case of arthroplasty infection caused by R minuta.
Cutrona Anthony F; Shah Munir; Himes Melissa S; Miladore Michael A
American journal of orthopedics (Belle Mead, N.J.)
2002
2002-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).