ABSTRACT
Patients with cancer frequently experience pain, and even with increased modern knowledge and skills in drug and other therapy, this pain is poorly controlled in a significant proportion. For these patients, a range of interventional techniques can play a significant role in providing pain relief. These include neuraxial administration of opioids and other drugs, temporary or permanent blockade of nerve pathways and minimally invasive management of bony and other metastases. Those involved in the treatment of pain from cancer should be aware of the scope of these techniques and ready to call upon specialists in their use.
Subject(s)
Analgesia/methods , Neoplasms/complications , Neoplasms/therapy , Pain Management , Pain/etiology , Humans , Neoplasms/drug therapy , Pain/drug therapy , Pain Measurement/methodsABSTRACT
We report a child with cartilage-hair hypoplasia and Hodgkin's disease who developed progressive renal failure and died following infection with a polyomavirus, BK virus. Renal biopsy showed interstitial inflammation, tubular atrophy, and intranuclear inclusions in tubular epithelium, with large numbers of papovavirus particles within the cells. BK virus infection was confirmed by polymerase chain reaction on renal biopsy material and in urine and the demonstration of a high titre of haemagglutination inhibition (HI) and IgM antibody to the virus in the patient's serum. This case emphasises the need to study in depth any unusual clinical manifestation in immunocompromised patients to delineate better the full clinical impact of less well-established pathogens such as BK virus.
Subject(s)
BK Virus , Immunologic Deficiency Syndromes/complications , Kidney Failure, Chronic/etiology , Opportunistic Infections/complications , Polyomavirus Infections/complications , Tumor Virus Infections/complications , Antibodies, Viral/blood , BK Virus/genetics , BK Virus/immunology , BK Virus/isolation & purification , Base Sequence , Cartilage/abnormalities , Child, Preschool , DNA Primers/genetics , DNA, Viral/genetics , Hair/abnormalities , Hodgkin Disease/complications , Humans , Kidney/pathology , Kidney/virology , Kidney Failure, Chronic/pathology , Kidney Failure, Chronic/virology , Male , Molecular Sequence Data , Polymerase Chain ReactionSubject(s)
Intubation, Intratracheal , Life Support Care , Wounds and Injuries/therapy , Education, Medical , England , Humans , Manuals as TopicSubject(s)
Diclofenac/adverse effects , Pain, Intractable/chemically induced , Adult , Female , Humans , ThighABSTRACT
The Duostim model TV02 is a new peripheral nerve stimulator designed both for nerve identification in the performance of regional anaesthesia and for monitoring neuromuscular blockade. The output pulses are unipolar and of adjustable constant current. The provision of single twitch (1 Hz and 1/15 Hz) train-of-four and tetanic stimuli, together with indication of the current delivered and the small size of the unit, facilitate its clinical use. Performance was assessed and found to be according to specification.
