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Twenty eight patients with severe, intractable spasticity have been treated by chronic intrathecal administration of baclofen. An implantable programmable drug-administration-device (DAD) was used with a permanent intrathecal catheter. Infusion of 50 to 800 micrograms/day of baclofen completely abolished spasticity. Follow-up was up to two years.(More)
Thirty-three patients with complete median, ulnar or digital nerve transections were studied 4 months to 13 years subsequent to suture or nerve grafting. In all cases, sensory disturbances, in terms of paraesthesia or hypaesthesia, were encountered. Painful or unpleasant symptoms, allodynia or hyperpathia, were observed most frequently in patients with poor(More)
We evaluated the concentration of the neuropeptide somatostatin (SOM) in the CSF of patients with several neurologic diseases. Since SOM is localized in high concentrations in primary sensory pathways, such as the dorsal root ganglia and dorsal horn of the spinal cord, it might be involved in conditions of chronic pain due to functional alterations of(More)
BACKGROUND Patients suffering out-of-hospital cardiac arrest (OOHCA) are generally transported to the closest ED, presumably to expedite a hospital level of care and improve the chances of return for spontaneous circulation (ROSC) or provide post-resuscitative care for patients with prehospital ROSC. As hospital-based therapies for survivors of OOHCA are(More)
BACKGROUND Endotracheal intubation (ETI) is commonly used by paramedics for definitive airway management. The predictors of success and therapeutic value with regard to oxygenation are not well studied. OBJECTIVES 1) To explore the relationship between intubation success and perfusion status, Glasgow Coma Scale (GCS) score, and end-tidal carbon dioxide(More)
OBJECTIVES This study sought to measure the impact of pre-hospital (PH) electrocardiography (ECG) on scene-to-hospital time for patients with chest pain of cardiac origin and those with ST-segment elevation myocardial infarction (STEMI). BACKGROUND Pre-hospital ECG decreases door-to balloon (D2B) time for STEMI patients. However, obtaining a PH ECG might(More)
Spasticity can affect individuals with spinal injury, spinal disease, or multiple sclerosis. In most cases, spasticity is useful because it helps compensate for motor deficits. Oral medication is ineffective or produces intolerable side effects in ≅ 30% of patients with severe spasticity and surgeries can sometimes have effects inappropriate for patients(More)
The effect of epidural opioids on spinal spasticity is demonstrated in a patient suffering from multiple sclerosis. Flexor reflex spasms are abolished and muscle tone is markedly reduced by the epidural administration of morphine 3 mg or fentanyl 0.1 mg. In contrast, the oligosynaptic motor responses and voluntary movements were unaffected. This is(More)
BACKGROUND Cardiac arrest is responsible for significant morbidity and mortality, with consistently poor outcomes despite the rapid availability of prehospital personnel for defibrillation attempts in patients with ventricular fibrillation (VF). Recent evidence suggests a period of cardiopulmonary resuscitation (CPR) prior to defibrillation attempts may(More)