5 research outputs found
Chemical toxic exposures and chronic ocular pain
Chronic ocular pain is a common, debilitating chronic pain condition with significant morbidity and negative impact in patients’ quality of life. Several, diverse types of insults to the ocular surface can lead to acute, and under certain conditions to chronic ocular pain, and these include toxic irritants. Exposure of ocular surface to toxic irritants, in addition to direct tissue injury, carries the capacity to generated intense immune and neuronal responses with hyper-excitability, sensitization and chronic pain. Because, chronic ocular pain subsequent to toxic exposures is relatively unrecognized clinical entity, this brief review highlights pertinent concepts of its epidemiology, pathogenesis/pathophysiology, clinical progression, with recommendations for its clinical management that clinicians may find helpful. Suppression of pain signaling, generating neuronal sensitization, and prevention of chronicity of neuropathic pain is particularly emphasized in this respect
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Neuraxial Block: Overview
This chapter outlines neuraxial block techniques and their related pharmacology and features relevant clinical applications and considerations for neuraxial blocks
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Noncancer Pain: Fibromyalgia
Fibromyalgia is a constellation of pain and psychological symptoms and is a diagnosis of exclusion. It can be physically and emotionally taxing to patients, sometimes interfering with their daily lives. Etiology of fibromyalgia is unknown but it is thought to be a disorder of central sensitization with CNS. American College of Rheumatology diagnostic tool for fibromyalgia is used for diagnoses of fibromyalgia and includes generalized pain (in ≥4 out of 5 regions), Symptoms for ≥3 months, Widespread pain index (WPI) ≥7 and symptom severity scale (SSS) score ≥5; OR WPI 4–6 and SSS ≥9, no other diagnoses can be made from clinical presentation. Treatment should be multidisciplinary including pharmacological and nonpharmacologic measures: patient education, treatment of comorbidity, slow graded exercise as tolerated; if symptoms do not improve, may add low dose TCA vs SNRI nightly +/− gabapentinoids; other medications including low dose naltrexone may be trialed
Factors Affecting Acoustics and Speech Intelligibility in the Operating Room: Size Matters
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